EMAS position statement: Vitamin D and menopausal health

Area of Science:

• Endocrinology
• Nutritional Science
• Gerontology

Background:

• Vitamin D deficiency is increasingly linked to non-skeletal health issues beyond osteoporosis.
• Associations include cardiovascular disease, diabetes, cancer, infections, and neurodegenerative diseases.
• Clarifying vitamin D's role in postmenopausal women's non-skeletal health is crucial.

Purpose of the Study:

• To provide an evidence-based overview of vitamin D's role in postmenopausal women's health.
• To synthesize findings from observational and interventional studies.
• To offer expert consensus on vitamin D status and supplementation.

Main Methods:

• Comprehensive literature review of observational and interventional studies.
• Consensus-building among expert opinion leaders.
• Analysis of serum 25-hydroxyvitamin D levels for status determination.

Main Results:

• Vitamin D deficiency (<20 ng/ml) is associated with adverse outcomes, including low bone mass and fracture risk.
• Supplementation with calcium may benefit skeletal health in deficient elderly women.
• Vitamin D may modestly improve lipid profiles and glucose homeostasis but not cardiovascular event incidence.
• Supplementation shows no effect on cancer incidence but may reduce cancer mortality.
• Vitamin D may decrease acute respiratory infections and COVID-19 severity.
• Supplementation shows limited effects on menopausal symptoms, except for vulvovaginal atrophy.

Conclusions:

• Vitamin D deficiency is prevalent and associated with various health risks in postmenopausal women.
• Supplementation benefits are most evident for skeletal health and potentially for infections when co-administered with calcium.
• Robust evidence for vitamin D supplementation's efficacy on cardiovascular disease, cancer incidence, and most menopausal symptoms is lacking.