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 .
Hormone replacement therapy and the prevention of postmenopausal osteoporosis
Fracture prevention is one of the public health priorities worldwide . Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis , the most common metabolic bone disease . Different effective treatments for osteoporosis are available . Hormone replacement therapy ( HRT ) at different doses rapidly normalizes turnover , preserves bone mineral density ( BMD ) at all skeletal sites , leading to a significant , reduction in vertebral and non-vertebral fractures .  Tibolone , a selective tissue estrogenic activity regulator ( STEAR ) , is effective in the treatment of vasomotor symptoms , vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT . Selective estrogen receptor modulators ( SERMs ) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures . The combination of bazedoxifene and conjugated estrogens , defined as tissue selective estrogen complex ( TSEC ) , is able to reduce climacteric symptoms , reduce bone turnover and preserve BMD . In conclusion , osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms . The use of a st and ard dose of HRT for osteoporosis prevention is based on biology , epidemiology , animal and pre clinical data , observational studies and r and omized , clinical trials . The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover , with compelling scientific evidence
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 .