Although the level of evidence for the effects of vitamin D on vaginal health is low in our study , we concluded that vitamin D may improve the vaginal health of women , especially during menopause
Menopause is associated with the onset of climacteric symptoms due to low estradiol levels , which may cause insufficient maturation of the vaginal mucosa .
Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels , thereby restoring vaginal health .
The objective of this systematic review , the first on this subject , was to investigate the effect of vitamin D on the  vaginal health of menopausal women .
A comparison of raloxifene and calcium plus vitamin D on vaginal atrophy after discontinuation of long-standing postmenopausal hormone therapy in osteoporotic women. A randomized, masked-evaluator, one-year, prospective study.
OBJECTIVES We assessed the effects of the discontinuation of long-st and ing transdermal estrogen replacement therapy ( > 4 years ) and substitution of this treatment by calcium or raloxifene on the vaginal epithelium and climateric symptoms in a study population of osteoporotic women . METHODS A total of 136 women ( mean age 55.5 years ) were r and omized to calcium ( 500 mg elemental calcium , 400 IU Vitamin D3 ) ( n=40 ) , raloxifene ( 60 mg/day ) ( n=48 ) , or estrogen patches ( 3.9 mg estradiol ) and progesterone ( 100 mg/day ) ( n=48 ) . Treatment was given for 1 year . The vaginal maturation value ( VMV ) , serum estradiol levels , and climateric symptoms using a 12-item modification of the SF-36 quality of life question naire were evaluated at baseline and at 6 and 12 months . RESULTS At 6 months , mean VMV decreased significantly ( P<0.001 ) in the calcium ( -51.8 % ) and raloxifene ( -18.6 % ) groups compared with baseline and the estrogen/progesterone group . At 12 months , significant decreases of mean VMV in the calcium ( -38.7 % ) and raloxifene groups ( -32 % ) ( P<0.001 ) were also observed . Serum estradiol levels and changes of VMV correlated significantly at 6 months ( rho=0.361 , P<0.01 ) and at 12 months ( rho=0.269 , P<0.035 ) . A significantly higher number of patients complained of hot flushes and palpitations in the calcium and raloxifene groups than in the estrogen/progesterone group . Raloxifene-treated women reported a significantly higher number of adverse events at 6 months compared to the other treatment groups . CONCLUSIONS Withdrawal and change of long-st and ing transdermal hormone replacement therapy by treatment with calcium or raloxifene result ed in worsening of vaginal atrophy assessed by the VMV , although it was not clinical ly perceived by the patients . However , increases in dyspareunia and urinary leaks were reported . Menopausal complaints related to vasomotor symptoms worsened in the calcium- and raloxifene-treated groups and persisted throughout the study period
Although the level of evidence for the effects of vitamin D on vaginal health is low in our study , we concluded that vitamin D may improve the vaginal health of women , especially during menopause
Menopause is associated with the onset of climacteric symptoms due to low estradiol levels , which may cause insufficient maturation of the vaginal mucosa .
Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels , thereby restoring vaginal health .
The objective of this systematic review , the first on this subject , was to investigate the effect of vitamin D on the  vaginal health of menopausal women .