Vitamin D and Menopause: Why It Matters for Bone, Muscle and Immune Health
- Jul 24, 2024
- 4 min read
Miyara Women | Jul 24, 2024 | Updated: Jul 30, 2024 Written by: Kanchana — Lifestyle Consultant & Weight Management Specialist, Calorie Culture
Raji has been sitting rooted to the couch on her balcony for a while now, with a distant look in her eyes. This has become a regular scene recently, quite in contrast to her usual self. Her energy levels are low; she often experiences muscle pain and allergies and has no enthusiasm even for daily chores. Nothing else has changed. Her family (and even she) thinks it is due to poor sleep — but despite sticking to a consistent sleep routine, a good night's rest remains elusive.
This is the real-life experience of someone from Team Miyara. Name changed.
What can help her?
Simple blood work led to her diagnosis: vitamin D deficiency.
Until about 15 years ago, this vitamin was thought to only cause rickets in children and osteomalacia in adults. Today, we know it dons multiple hats — elevated to the status of a hormone. Lower vitamin D levels are associated with depression, mood swings, brain fog, stress urinary incontinence, pelvic organ prolapse, sleep disturbances, and sexual dysfunction. In short, low vitamin D can worsen the full spectrum of menopause symptoms.
Despite being a "super vitamin," approximately 1 billion people worldwide are deficient, and ~50% of the global population is insufficient. And here is the paradox India lives with: even with abundant year-round sunshine, a cross-sectional study of perimenopausal women in Kerala found 89.1% were vitamin D deficient — with mean levels far below the required 30 ng/mL. The modern indoor lifestyle, use of sunscreen, and pigmented skin (which produces less vitamin D in sunlight) are largely to blame.
Why Is Vitamin D Important for Women?
Strong Bones — Vitamin D ensures calcium is absorbed and deposited in bones. The 2023 EMAS Position Statement on Vitamin D and Menopausal Health — the most authoritative clinical guidance on this topic, developed by 21 European menopause specialists — confirms that vitamin D deficiency is directly associated with low bone mass and increased fracture risk, and that supplementation at 800–2000 IU/day co-administered with calcium benefits bone health, particularly in older women.
Muscle Health — Vitamin D positively influences muscle mass, exercise capacity and performance, as well as muscle contraction and strength — particularly important for preventing muscle loss with age.
Immune Support — Vitamin D plays a role in the maturation of antibodies and protective immune cells. Deficiency is associated with higher risk of autoimmunity and certain cancers.
Mood Regulation — Vitamin D may regulate mood by increasing serotonin, the feel-good hormone. Low levels have been linked to an increased risk of depression.
Reproductive Health — Low vitamin D status is associated with increased risk of PCOS, endometriosis, and infertility. During perimenopause, deficiency is linked to genitourinary symptoms like vaginal dryness and recurrent urinary infections — with the EMAS statement noting vitamin D supplementation shows a modest benefit specifically for vulvovaginal atrophy.
Other Proposed Benefits — While research is still emerging, vitamin D is believed to aid cardiometabolic health — including insulin resistance, blood pressure regulation, and cholesterol — through menopause.
How Much Vitamin D Do You Need?
The recommended daily intake varies by age:
Adult women up to 70 years: 400–600 IU
Adult women over 70 years: 800 IU
Most experts agree that supplementing with 1000 IU per day is safe. The EMAS statement recommends 800–2000 IU/day at maintenance after initial repletion, always co-administered with adequate calcium.
How Do You Get Enough?
Your body can make it — all you need is 15–20 minutes of daily direct sun on bare skin, though the optimal time differs by location. Alternatively: supplements, or food sources such as fatty fish, red meat, egg yolks, liver, UV-treated mushrooms, and fortified foods.
What Causes Your Vitamin D Levels to Fall?
Insufficient sun exposure, sunscreen use, geographic location, age, darker skin pigmentation, and conditions like Crohn's disease, kidney or liver disease, and obesity can all reduce levels. The risk may also increase with age due to poorer intestinal absorption, though research on this remains inconclusive.
How Can I Know If I Have Enough?
A simple blood test measures serum 25(OH)D levels. Deficiency is defined as below 20 ng/mL; levels from 21–29 ng/mL are considered insufficient.
Summing It All Up
Vitamin D deficiency is now considered a worldwide pandemic — and 70% of postmenopausal women globally are affected. Meeting the daily requirement through food alone is difficult, and supplementation is essential without adequate sun exposure. Vitamin D could be behind those nagging complaints — fatigue, aches, mood swings, frequent illness. Prioritise this sunshine vitamin and take a step towards better overall well-being.
Download the Free Miyara Perimenopause Companion App
About the author
Kanchana is a Lifestyle Consultant & Weight Management Specialist. After a Masters degree in Molecular Biology from the USA, she ventured into the field of Nutrition and is certified in General Nutrition, Sports Nutrition, and Weight Management. Her own successful weight loss journey inspired her to help people of all age groups and health conditions via Calorie Culture, which she founded in 2012. She is also an avid dancer, mini marathoner, and sports enthusiast. She strongly advocates sustainable lifestyle changes as a means to long-term health benefits and optimal weight.
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