For years now, we’ve known IC and pelvic floor dysfunction (PFD) go hand-in-hand. Many patients have overly tight pelvic floor muscles that at least contribute to their pelvic pain.
Treating PFD is important. It typically starts with pelvic floor physical therapy and can eventually include vaginal suppositories or trigger point injections. If nothing else helps, then BotoxA and neuromodulation are options.
More and more research shows vitamin D also plays a big role in pelvic floor health for women. This doesn’t mean we need to take a bunch of vitamin D and avoid all other lines of treatment for PFD. But it is worth taking a look at the research and deciding if upping your vitamin D levels is a good choice for you.
The Role of Vitamin D
Understanding the role vitamin D plays in our overall health is important. You may have heard most that vitamin D helps your body absorb calcium, which improves bone health. And that’s true. But it does more than that!
Vitamin D also helps with muscle health and proper functioning of the immune and nervous systems.(1) These three aspects of vitamin D are of particular interest in the IC community. Firstly, help with muscle health is important for those patients who deal with PFD. Improving muscle health can only aid in teaching the muscles to relax and function normally.
Secondly, vitamin D helps with proper function of the immune system. IC is not considered an autoimmune disease, per se, but it does have some overlapping characteristics. The production of mast cells that cause bladder pain, for example, are an immune system response. This is why antihistamines are a line of treatment for IC patients.
Finally, proper function of the nervous system is another component of vitamin D. IC is not considered to be a completely neurological condition, but there is an overlap with it. The nerves in the bladder and pelvis can get over-excited, so to speak, and strongly react even when there is no issue. It’s why certain antidepressants are a line of treatment for IC because they help settle down the nerves.
Combined together, the functions of vitamin D could have an impact on treating IC and PFD.
Vitamin D and the Pelvic Floor
More and more research is showing evidence of vitamin D deficiency in PFD patients, including those with pelvic organ prolapse. Vitamin D deficiency has been looked at for contributing to a variety of health conditions, but of them all, musculoskeletal health is most impacted by its deficiency. Because the female pelvic floor is a balance of both muscle and bones, it is susceptible to the impact of vitamin D deficiency.(2)
Research seems to back this up. Studies have found vitamin D levels were significantly lower in PFD patients than in the control of healthy women. No other significant variables were found.(3) Pelvic organ prolapse patients also have a higher prevalence of vitamin D deficiency than control groups.(4)
Risk Factors for Vitamin D Deficiency
To understand who is at risk for vitamin D deficiency, we must first understand its sources. Vitamin D includes both D2 and D3. The body processes them exactly the same way, so either work well. They are fat-soluble vitamins. Vitamin D2 is found in very few foods naturally, but some foods are fortified with it. Vitamin D3 is found in fatty fish, beef liver, butter and egg yolks.(1)
However, the most common natural source of vitamin D is the sun and exposure to UVB rays.
Just having PFD does not necessarily mean you are vitamin D deficient. Aside from a blood test, knowing the other risk factors for lower vitamin D levels can help you discern whether it may be an issue for you.
If you have lighter skin, then five to 10 minutes of sun exposure to your hands and face each day may be enough. Those with darker skin or who cover up in the sun and/or are fastidious about applying sunscreen may have a harder time getting enough sun exposure.(1)
Seasons are also a factor. Lower levels of vitamin D are more common during the winter months when people aren’t outside as much. Those living in areas of higher latitudes also may struggle since there is less sunlight, particularly during the winter months.(2)
Older adults also have an increased risk for vitamin D deficiency because as we age, our skin gradually decreases its ability to synthesize vitamin D.(5)
If you have a blood test of your vitamin D levels, the National Institutes of Health agrees the level should be between 30 and 50.(5)
Increasing Vitamin D
Whether you know you are vitamin D deficient from a blood test or suspect it due to risk factors, there are healthy and safe ways to increase your vitamin D levels. Women 19 to 70 need 600 IU of vitamin D per day, and women over 70 need 800 IU.(1)
Foods with vitamin D
While sun exposure is often the biggest focus for vitamin D, it is found in food as well.(6)
- Fatty fish like salmon, halibut and mackerel
- Herring and sardines
- Cod liver oil
- Canned tuna
- Egg yolks
- Mushrooms
- Vitamin D-fortified foods like cow’s milk, soy milk, some cereal and some oatmeal
Find an even more detailed list with calorie counts and amount of vitamin D here.
Spend time in the sun
Tanning beds are NOT recommended for increasing vitamin D levels, because of the greater risk for skin cancer as a result. You can, however, sit outside in the sun for a few minutes each day and absorb its rays through your hands and face.
The good news is just a little sun exposure on unprotected skin causes your body to produce more vitamin D.(7)
Take a supplement
If food and sunshine aren’t great options for you, then take a vitamin D supplement. Around 35% of women 20 and older take vitamin D supplements. (I’m one of them due to extreme skin sensitivity to the sun.) Taken in the recommended doses of 800 to 1,000 IU a day, vitamin D supplements are considered very safe.(1)
An 800 IU dose taken consistently, for example, increases your vitamin D level by 10 points. So adding in a supplement and slathering on sunscreen when you’re outdoors may be the healthiest option to increase your vitamin D.(1)
References:
- Gunter J. The Menopause Manifesto. Citadel Press. 2021.
- Sharma S, et. al. Vitamin D and Pelvic Floor Disorders. J Mid-Life Health. Vol. 8, No. 3, July-Sept 2017.
- Ghanbari Z, et. al. Vitamin D Status in Women with Pelvic Floor Disorders: A Meta-Analysis of Observational Studies. J Mid-life Health. Vol. 10, No. 2, Apr-Jun 2019.
- Legan M, et. al. Association of vitamin D deficiency and pelvic organ prolapse in postmenopausal women: a cross-sectional study. Women’s Midlife Health. Vol. 9, No. 8, Aug 2022.
- National Institutes of Health. Vitamin D: Fact Sheet for Health Professionals. Sept. 18, 2023.
- Jones T. 7 Nutritious Foods that are High in Vitamin D. Healthline. July 6, 2023.
- Hill A. 7 Ways to Increase Your Vitamin D Levels. Healthline. March, 15, 2023.
