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 .
Comparing the effects of continuous hormone replacement therapy and tibolone on the genital tract of menopausal women; a randomized controlled trial.
INTRODUCTION Many postmenopausal women who are on hormone replacement therapy discontinue medications due to vaginal bleeding .  Tibolone , a synthetic steroid , has minimal stimulatory effect on the endometrium . The aim of this study was to assess the effects of continuous HRT regimen and tibolone on the onset of vaginal bleeding and vaginal maturation value . MATERIAL S AND METHODS A total of 150 healthy women in postmenopausal period were r and omly enrolled in this controlled clinical trial . Patients were r and omly allocated into three groups , and were followed for six months . The first 50 women received 2.5 mg tibolone plus a Cal+D tablet ( 500 mg Calcium and 200 IU vitamin D ) daily , the second 50 women received 0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesterone acetate ( CEE/MPA ) plus one Cal+D tablet daily , and the remaining 50 received only one Cal+D tablet per day and served as the control group . Symptoms were recorded using a question naire that assessed vaginal bleeding or spotting , vaginal dryness and intention to continue the medications . Vaginal maturation value was assessed by examining vaginal smears before and after the treatment . The results for the three groups were analyzed using statistical methods . RESULTS In comparison with the control group , CEE/MPA and tibolone increased vaginal maturation value and decreased the frequency of vaginal dryness ( p < 0.01 ) . Women in tibolone group were more likely to continue the treatment regimen than those in the CEE/MPA or the control groups ( p < 0.01 ) . CONCLUSION Tibolone can serve as an appropriate choice for HRT as it has low rates of vaginal bleeding/ spotting episodes and high acceptance rate in postmenopausal women
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 .