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Postmenopausal sexual arousal improved 44% by topical vitamin D (not oral) – meta-analysis Feb 2025


The effectiveness of vitamin D as an alternative to FDA-approved treatment and other therapies for managing vulvovaginal atrophy and sexual inactivity in postmenopausal women. A systematic review and meta-analysis

Int J Gynaecol Obstet. 2025 doi: 10.1002/ijgo.70011 Eman Youssef 1, Mostafa Saad Badie 2, Doaa Ismail 3, Aliaa Gamal 4, Hala Mohamed Eldamanhoury 5

Background: Vulvovaginal atrophy (VVA) and sexual inactivity (SI) are prevalent among postmenopausal women (PMW). While hormonal therapies show significant improvement, non-hormonal therapies are considered the first-line for breast cancer women. However, vaginal hormonal therapies are unavailable in all countries, particularly developing countries such as the middle east, and there are no studies that have tested these therapies in women either with a history of breast cancer or those taking endocrine therapies for their cancer.

Objective: We conducted this meta-analysis to evaluate the effectiveness of vitamin D (VD), whether alone or in combination with other therapies, in managing VVA and SI in PMW.

Search strategy: A systematic literature search was undertaken on four electronic databases (Web of Science, PubMed, Cochrane, and Scopus) from inception until June 2023.

Selection criteria: The randomized controlled trials (RCTs) that used the vaginal maturation index (VMI) and vaginal pH to measure VVA and vaginal dryness and the female sexual function index (FSFI) to measure SI were included in the meta-analysis.

Main results: Eight RCTs (608 PMW) were included, and 222 were assigned to the VD arm. For the oral VD subgroup, there was no statistically significant improvement in the mean difference (MD) of VMI (MD -7.62, 95% confidence interval [CI]: -23.84, 8.59). However, VMI's topical VD subgroup was statistically significant (25.16; 95% CI: 18.74, 31.59).
For topical form, the total FSFI score (0.24; 95% CI: -1.72, 2.20) and all FSFI domains did not demonstrate statistically significant improvement except arousal (0.56; 95% CI: 0.12, 1.00). Vaginal pH's oral VD subgroup showed statistically significant improvement (-0.27, 95% CI: -0.50, -0.05) compared to the topical VD.
Topical VD subgroup (24.45; 95% CI: 7.14, 41.77) showed a statistically significant increase of vaginal superficial cells, in contrast to the oral VD subgroup (3.25; 95% CI: -5.44, 11.96).

Conclusion: Topical VD showed significant improvements in VMI and the arousal subscale of FSFI, whereas oral VD had no substantial improvement except in vaginal pH. VD alone is not a sufficient alternative to other available treatments, and further RCTs are needed to evaluate its effectiveness without any combination with other drugs.


No details in abstract about dose size, type, or where it was applied

Suspect Topical vitamin D was applied directly to the vagina,
Previous studies appear to have found that topical gets about 100X more vitamin D just under the skin than oral vitamin D


VitaminDwiki used to pay about $1,000 a year rent or buy access to studies, but has been running low on funds

publisher rents PDF for $16


VitaminDWiki – Topical Vitamin D category contains:

Topical is one of the many ways of increasing the vitamin D in your body
Topical is 2X to 50X more expensive than oral form
Topical is great for those who not want to swallow pillls nor fortifiy their food/drink with Vitamin D
Topical is one of the many gut-friendly forms of vitamin D (good bioavailability for those with poor guts
Topical is especially good form to apply directly to skin problems:
    - i.e. Psoriasis  Warts  Burns  Acne  Eczema  Wounds  (lasts about a day)
    The skin, like most tissues of the body, can fully-activate Vitamin D locally - no liver nor kidney needed.
Provides perhaps 100X higher concentration of Vitamin D to that portion than if same dose were taken orally
There were 98 topical Vitamin D products on Amazon Sept 2024 Creams, oils, patches, nanoemulsions, etc.
   I prefer Nutrasal nanoemulsion form
Suspect that topical Vitamin D is best absorbed where the skin gets Vitamin D naturally
- - - face and hands vs the back or the inside of arms
Nanoemulsions can also be applied topically under the tongue and inhaled


17+ VitaminDWiki pages have MENOPAUSAL in the title

The list is automatically updated

Items found: 17
Title Modified
Vitamin D response in post-menopausal women: weekly better than monthly, notice benefit in 3 months – Jan 2021 23 Dec, 2023
Menopause delayed and symptoms decreased by Vitamin D - many studies 23 Dec, 2023
Pelvic Organ Prolapse after menopause 5.6 X more likely if low Vitamin D (weak muscles) – Oct 2023 02 Oct, 2023
Menopause is earlier in black women (low vitamin D) - Aug 2023 25 Aug, 2023
Age of menopause increases if add vitamin D or UVB 25 Aug, 2021
Menopause 3 years later in women eating fatty fish (Omega-3) – April 2018 07 May, 2018
Risk of early menopause reduced 17 percent by a modest amount of vitamin D – May 2017 11 May, 2017
The Role of Vitamin D in Menopausal Medicine – Jan 2016 19 Jan, 2017
Vitamin D and menopause -A narrative review – July 2014 16 Oct, 2015
Post menopausal vaginal dryness treated with vitamin D vaginal suppositories – RCT March 2015 16 Sep, 2015
Breast Cancer: 26 percent less risk if menopausal hormone therapy plus vitamin D – Sept 2015 12 Sep, 2015
Menopause group advises too little vitamin D supplementation etc. – Jan 2012 25 Jun, 2015
400 IU Vitamin D did not affect menopause (400 IU affects virtually nothing) - RCT May 2015 01 Jun, 2015
Women taking Vitamin D had fewest deaths after post-menopause breast cancer – May 2013 15 Nov, 2014
Menopause and vitamin D – a narrative review (which costs 36 dollars) – June 2014 06 Jul, 2014
Breast Cancer post menopause down 12 percent for every 5 ng of vitamin D – meta-analysis May 2013 28 Oct, 2013
Diurnal variation in blood levels noted for post-menopausal women – 2002 20 Jun, 2010

6+ VitaminDWiki pages have SEXUAL in the title

The list is automatically updated

Items found: 6