Vitamin D in endometriosis: a causative or confounding factor?

Area of Science:

• Reproductive endocrinology
• Immunology
• Nutritional science

Background:

• Endometriosis is a complex gynecological condition.
• Vitamin D plays crucial roles in immune function and inflammation.
• The endometrium expresses vitamin D receptors and metabolizing enzymes.

Purpose of the Study:

• To review existing evidence on the relationship between vitamin D and endometriosis.
• To explore the potential biological mechanisms linking vitamin D to endometriosis pathogenesis.

Main Methods:

• Systematic literature search of Medline publications from 1946 to June 2013.
• Comprehensive review of study findings.

Main Results:

• Vitamin D levels and intake may affect endometriosis risk.
• Vitamin D pathway components are present in the endometrium, with dysregulation in endometriosis.
• Potential mechanisms include immunomodulation and HOXA10 gene expression.
• Gc2 phenotype of vitamin D binding protein is more common in women with endometriosis.
• A vitamin D receptor agonist reduced endometriotic lesions in a mouse model.

Conclusions:

• Biological plausibility exists for vitamin D's role in endometriosis pathogenesis and treatment.
• Current human evidence is sparse, primarily from case-control studies.
• A clear cause-effect relationship cannot be established due to limited data.
• Placebo-controlled supplementation trials are recommended for further investigation.