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Pelvic Organ Prolapse after menopause 5.6 X more likely if low Vitamin D (weak muscles) – Oct 2023

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Association of Low Vitamin D Level with Pelvic Organ Prolapse in Post Menopausal Women: A Case Control Study – Oct 2023

Mymensingh Med J . 2023 Oct;32(4):1109-1117.
Z R Paul 1, N N Khanam, S C Barai, A A Chowdhury, S G Krishna, R Masud, D Rafaha, S Akter

Pelvic organ prolapse refers to protrusion of the pelvic organ into or out of the vaginal canal. One in four women in the USA suffer from some type of pelvic floor disorder including pelvic organ prolapse and frequency of pelvic organ prolapse is more with increasing age. In Bangladesh, 15.6% women suffered from pelvic organ prolapse and more than 11.0% of women require surgical correction of prolapse in their life times. According to few researches, there is an observed association between low vitamin D levels with pelvic organ prolapse but this finding is not unequivocal. This case control study has been conducted in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from October 2018 to August 2020 to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of low vitamin D with pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. All necessary Data were collected on variables of interest by using the structured questionnaire pre-designed for interview, observation, clinical examination, and biochemical Data collection. Distributions were expressed by mean and standard deviation for continuous variables and by frequency and percentage for qualitative variables. Student's t-test and Chi square test were done to see the significance of differences between Group I and Group II. Odds ratio, correlation coefficient, and multivariate logistic regression analysis was done to assess the association of low vitamin D level with pelvic organ prolapse. Mean±SD level of Vitamin D in the case group was 13.96±5.18ng/ml and in the control group was 21.08±5.77ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse. OR (95% CI), of two groups showed risk of developing pelvic organ prolapse 5.63 times higher in women with decreased vitamin D level. Thus it can be concluded that women having low level of vitamin D have more chance of developing pelvic organ prolapse.


Differences Between 25-hydroxyvitamin D Levels in Patients with Pelvic Organ Prolapse and Non-Pelvic Organ Prolapse: A Systematic Review – Aug 2023

Journal of Obstetrics and Gynaecology Canada 102198 https://doi.org/10.1016/j.jogc.2023.102198
Eighty Mardiyan Kurniawati MD, PhD 1, Nur Anisah Rahmawati MPH 2, Anis Widyasari MD 3

Authors probably have low vitamin D levels
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Objectives
Treatment options for cases of pelvic organ prolapse still lead to the use of a pessary rather than a surgical method. Additional therapy is needed to help treat or prevent pelvic organ prolapse. Vitamin D deficiency has consistently been associated with decreased muscle function, so it is assumed that it will affect the pelvic floor muscles. This paper systematically explores the differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse.

Study Design
A systematic review was conducted through the PubMed, Google Scholar, Cochrane Library, and ScienceDirect databases using relevant keywords. Articles published in the last 10 years—from 2012 to 2022—that were written in English, that discuss the status or effect of vitamin D on pelvic organ prolapse, and that focus on 25 OH-vitamin D were included in the review.

Results
In total, 717 articles were filtered but 8 articles met the criteria. A total of 1339 women with prolapse and without prolapse with ages ranging from 20 years to 78 years were included in the study. The studies found did not use the same standard threshold in determining deficiency status. Most studies have found that there are lower levels of vitamin D in women who have had pelvic organ prolapse. A total of 7 of 8 studies confirmed the comparison of vitamin D-25OH levels in women with pelvic organ prolapse and without pelvic organ prolapse at P < 0.05.

Conclusions
There are differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse.
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Association of vitamin D deficiency and pelvic organ prolapse in postmenopausal women: a cross-sectional study – Aug 2022

Women's Midlife Health Vol 8, Article number: 9 (2022)
Mateja Legan, Matija Barbič, Joško Osredkar & Mija Blaganje

Background
Vitamin D is vital for skeletal integrity as well as optimal muscle work. High incidence and prevalence of vitamin D deficiency as well as pelvic organ prolapse are found in postmenopausal women, thus raising the question of whether the entities could be related.

Methods
We compared 50 postmenopausal women aged 50 to 75 years with pelvic organ prolapse (POP) with 48 women of same age without POP. The clinical assessment of the disorder was performed using the Pelvic Organ Prolapse Quantification system (POP-Q). An anamnestic questionnaire was filled out by the participants on their anthropometric data, life habits, reproductive history, previous and actual diseases. A blood sample was collected for determination of 25-OH-vitamin D as well as calcium and phosphorus concentrations.

Results
The group with POP and the control group were comparable in body mass index, physical activity, life habits and general health, but differed significantly in parity (being higher in POP) and vitamin D blood level concentrations, being lower in POP patients. A significantly higher prevalence of vitamin D deficiency (25-OH-vitamin D < 50 nmol/l) was found in the POP group compared to controls. Taking into account the confounding variables the logistic regression model confirmed the significant role of vitamin D for POP.

Conclusions
Vitamin D deficiency might be an important systemic factor associated to pelvic organ prolapse. The determination of vitamin D levels in postmenopausal women and replenishing its deficiency might also be of importance for the pelvic floor.
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VitaminDWiki – Muscles and Vitamin D - many studies contains:

To build muscles you need more than just Vitamin D
   also need Exercise, Protein, Magnesium, Omega-3, and activated Vitamin D Receptors
     In fact, Vitamin D monotherapy sometimes DECREASES muscles.

Notes on Vitamin D Receptor:
Vitamin D Receptors get vitamin D in the blood to the muscle cells
Approximately 20% of people have poor vitamin D receptors
As people age, their Vitamin D receptors also become less activated
There are 12+ low-cost activators for the Vitamin D Receptor
142+ VitaminDWiki pages have MUSCLE in the title
Dr. Greger on Vitamin D and Muscles - May 2020
Vitamin D Supplements for Increasing Aging Muscle Strength

  • "We have known for more than 400 years that muscle weakness is a common presenting symptom of vitamin D deficiency"
  • conservative "U.S. Preventive Services Task Force, the official prevention guideline setting body, and the American Geriatric Society to “recommend vitamin D supplementation for persons who are at high risk of falls.”
  • AGS recommends 4,000 IU to capture 92 percent of the population"

VitaminDWiki Sarcopenia (muscle loss) fought by Vitamin D, exercise and protein - many studies contains

To gain muscle, many studies have found that you need some of the following:
Exercise - just even walking (Intermittent high intensity exercise is much better)
Vitamin D - at least 800 IU/day,
    Loading dose will show improvements in weeks instead of 4+ months
Protein - perhaps 1gm/kg/day in a form appropriate for existing stomach acid
Calcium - 300 mg?
Omega-3

Includes the following studies:

  • Muscle loss with aging (Sarcopenia) is 7.7 X more likely if Vitamin D deficient – July 2023
  • Every trial found Scopenia to be associated with low vitamin D - Meta-analysis 2018
  • Sarcopenia 1.6X more likely if you have a poor VDR – Nov 2020

See also Bone Health   reduce falls and fractures   Frailty and Vitamin D - many studies   Muscles and Vitamin D - many studies


Attached files

ID Name Comment Uploaded Size Downloads
20162 POP cross-section_CompressPdf.pdf admin 02 Oct, 2023 179.92 Kb 123
20161 types of POP.png admin 02 Oct, 2023 286.34 Kb 178
20160 Pop review authors.png admin 02 Oct, 2023 309.49 Kb 85
20159 Pop review_CompressPdf.pdf admin 02 Oct, 2023 305.51 Kb 51