ARTICLE
Vitamin D in the management of endometriosis
Bradley McEwen | PhD , MHSc ( Hum Nutr ), BHSc , ND ( Adv ), DBM , DNutr , DSM , M . ATMS , Naturopath , Nutritionist , and Mentor . Adjunct Senior Lecturer , School of Health and Human Sciences , Southern Cross University .
Abstract Endometriosis is a chronic multifactorial and severe complex disease that affects about 15 % of women of reproductive age . Some of the symptoms of endometriosis include dysmenorrhoea , development of scarring and adhesions , pain , chronic pelvic pain , inflammation , and infertility . Vitamin D is involved in modulating inflammation and immune system function , differentiation , regulation of cellular growth , and overall metabolic function . Endometrial tissue expresses vitamin D receptors and enzymes involved in the metabolism of Vitamin D . A deficiency of vitamin D has been associated with endometriosis , menstrual dysfunction , polycystic ovary syndrome , impaired fertility , and a higher than normal occurrence of uterine myomas ( fibroids ). Vitamin D shows potential in the management of endometriosis .
Introduction
March is Endometriosis Awareness Month . In this issue of JATMS , there are several articles discussing lifestyle and nutritional management of endometriosis , such as meditation , magnesium , and Vitamin D . Endometriosis is a multifactorial and severe complex disease that often requires multitherapeutic strategies to manage the symptoms . 1 Women with endometriosis experience dysmenorrhoea , 2-8 pelvic floor muscle spasm , 9 pelvic pain , 2-7 chronic pelvic pain , 10 , 11 dyspareunia , 2-8 bowel conditions , 2-7 , 10 , 12 and thyroid conditions . 12 Optimum nutrition is the foundation for optimum health . 13 Diet , nutrition , and lifestyle can increase the risk of developing endometriosis . 14
A previous article published in this journal 15 discussed the potential of herbal medicines in the management of endometriosis . Research suggests that the metabolic pathways of vitamin D may play a key role in the development of gynaecological diseases . 16 A deficiency of vitamin D has been associated with endometriosis 17 and menstrual dysfunction . 16 Vitamin D receptormediated signalling pathways and vitamin D levels appear to affect the risk of several gynaecological diseases , such as endometriosis and polycystic ovary syndrome ( PCOS ). 16 A large prospective study conducted over a 14-year period found that women in the highest quintile of vitamin D level had a 24 % lower risk of endometriosis than women in the lowest quintile ( rate ratio = 0.76 , 95 % confidence interval : 0.60 , 0.97 ; P = 0.004 ). 8 Higher serum concentrations of vitamin D could be connected with a lower risk of developing endometriosis . This article aims to bring attention to the beneficial effects of Vitamin D in the management of endometriosis .
Endometriosis
Endometriosis is a chronic severe multifactorial inflammatory disease characterised by the presence of endometrial tissue outside the uterine cavity . 3 , 5 , 8 , 10 The endometrium of women with endometriosis presents abnormalities on a structural and functional level affecting proliferation ability , adhesion molecule expression ,
24 | vol27 | no1 | JATMS