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Vitamin D helps relieve menstrual symptoms

Vitamin D helps relieve menstrual symptoms

Friday, March 2, 2012. A research letter published in the February 27, 2012 issue of the American Medical Association journal Archives of Internal Medicine reported the results of a study of women with primary dysmenorrhea which found that a single high dose of oral vitamin D3 reduced pain over a two month period. Dysmenorrhea is characterized by painful uterine cramping which is often accompanied by nausea, vomiting, diarrhea, and other symptoms. The condition affects at least half of premenopausal girls and women, and can have a major impact on work and school attendance and performance.

Excessive uterine production of hormone-like substances known as prostaglandins is a major cause of dysmenorrhea, which is commonly treated with nonsteroidal anti-inflammatory drugs.

For the current trial, Antonio Lasco, MD, Antonino Catalano, MD and Salvatore Benvenga, MD of the University of Messina in Italy enrolled forty women between the ages of 18 and 40 who reported at least four painful periods over the previous six months and whose serum 25-hydroxyvitamin D levels were lower than 45 nanograms per milliliter. Twenty participants were administered 300,000 international units (IU) vitamin D3 five days before the beginning of their next menstrual cycle, while the remainder received a placebo. Pain symptoms were scored before treatment and at one and two months.

A correlation was observed at the beginning of the study between increased pain scores and reduced serum vitamin D levels. Women who received vitamin D reported a significant reduction in pain over two months compared to the placebo group. While 40 percent of subjects who received a placebo took nonsteroidal anti-inflammatory drugs for pain at least once over the course of the trial, none who received vitamin D reported needing the drugs. The greatest benefits were observed among those reporting the highest level of pain at the beginning of the study. The authors explain that vitamin D decreases proinflammatory cytokines and regulates the expression of genes involved in the prostaglandin pathway, reducing prostaglandin activity.

In an invited commentary in the journal, Elizabeth R. Bertone-Johnson, ScD and JoAnn E. Manson, MD note that it is important to determine how long a reduction in pain in association with a single dose of vitamin D would last. They note that "If 300 000 IU is required every 2 months, this would equate to approximately 5000 IU per day, considerably higher than the tolerable upper intake level set by the Institute of Medicine of 4000 IU/day."

"If these findings are confirmed in future randomized trials, vitamin D supplementation may become an important new treatment option for women who experience menstrual pain disorders" they conclude.

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Vitamin D levels reduced in trauma patients

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The 2012 Annual Meeting of the American Academy of Orthopedic Surgeons was the site of the presentation of the finding of widespread vitamin D insufficiency among orthopedic trauma patients.

Brett D. Crist, MD of the University of Missouri and his associates evaluated data from 1,830 adult trauma center patients who were seen from January, 2009 through September, 2010. Deficient serum vitamin D levels, defined as less than 20 nanograms per milliliter, were detected in 39 percent of the men and women, and 38.4 had insufficient levels between 20 and 32 nanograms per milliliter. While those between the ages of 18 to 25 had the lowest incidence of deficiency, deficient levels were still found in 29 percent of this group, and 54.7 percent had vitamin D insufficiency.

The findings of the current study are significant "as vitamin D deficiency has been linked to increased incidences of fracture nonunions (bone breaks that fail to heal)," noted Dr Crist, who is codirector of the Orthopedic Trauma Service of the University of Missouri's Department of Orthopedic Surgery.

"Vitamin D deficiency affects patients of all ages and is more prevalent than we thought it was," he admitted. "Although we've gone to treating most patients with weekly high dose vitamin D, in addition to daily vitamin D and calcium, monitoring vitamin D levels can be done to diagnose and monitor levels."

He added that vitamin D deficiency is "easy to manage," and "can prevent future fractures and improve healing of current fractures."

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