Vitamin D in the management of endometriosis

Endometriosis is a chronic severe multifactorial inflammatory disease. The endometrium of women with endometriosis presents abnormalities on a structural and functional level affecting proliferation ability, adhesion molecule expression, steroid and cytokine production, and presence of immune components.

Endometriosis is one of the most common gynaecological diseases affecting around 15% of women of reproductive age. Women with endometriosis experience dysmenorrhoea, dyspareunia, development of scarring and adhesions, pelvic floor muscle spasm, chronic pelvic pain, chronic pain, inflammation, irritable bowel syndrome, inflammatory bowel disease, constipation, fatigue, stress, chronic stress, and negative impact on quality of life.

Impairment of immunologic mechanism and inflammatory responses has been suggested to be involved in the pathogenesis of endometriosis.

Women with endometriosis experience autoimmune diseases, such as lupus and multiple sclerosis.

Vitamin D is involved with the absorption and metabolism of calcium, calcium homeostasis, mineral homeostasis, bone metabolism, modulating inflammation, differentiation, regulation of cellular growth, anti-proliferation, regulation of genes that are crucial for glucose and lipid metabolism, and overall metabolic function.

Vitamin D plays an essential role in cell-mediated and humoral antibody response and in the regulation of the response of the immune system.

A deficiency of vitamin D has been associated with endometriosis, menstrual dysfunction, polycystic ovary syndrome (PCOS), impaired fertility, higher occurrence of fibroids, bacterial vaginosis, insulin resistance, cardiovascular disease, autoimmune diseases, multiple sclerosis, and lupus.

Reference: McEwen B. Vitamin D in the management of endometriosis. JATMS 2021; 27(1):24-26.

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