Vitamin D, Calcium Supplements May Not Ease Menopause Symptoms

By Will Boggs MD

NEW YORK - Supplementation with vitamin D and calcium appears to have little effect on menopausal symptoms, according to results from the Women's Health Initiative Calcium/Vitamin D Supplementation Trial (CaD).

"When consulting with patients, physicians should be aware that there is no evidence that low-dose vitamin D and calcium supplements will help to improve symptoms such as hot flashes, mood swings, fatigue, or muscle aches," Dr. Erin S. LeBlanc, from Kaiser Permanente Center for Health Research, Portland, Oregon, told Reuters Health by email.

"This is just one study, however, and doctors need to be aware that professional bodies and experts who study vitamin D disagree on whether women need to take vitamin D supplements," Dr. LeBlanc said. "Doctors should take into account a woman's diet, age, sunlight exposure, and all of the evidence before they decide whether to suggest vitamin D supplements for an individual patient."

Vitamin D supplementation improves mood and muscle aches in nonmenopausal populations, whereas calcium has been linked to the occurrence of menopausal hot flashes.

Dr. LeBlanc's team hypothesized that the potential favorable effects of vitamin D on menopause-related symptoms would outweigh the potential negative effects of calcium. They examined the effects of 1000 mg elemental calcium carbonate plus 400 IU of vitamin D3 in a placebo-controlled trial of 34,157 women.

Women randomized to calcium and vitamin D supplementation had a similar number of menopausal symptoms (mean, 6.26) as those randomized to placebo (mean, 6.32), according to the June 1 Maturitas online report.

In secondary analyses of individual symptoms, the two groups did not differ in the level of sleep disturbance, emotional well-being, or energy/fatigue, and there was no evidence that hormone therapy modified the effects of supplementation.

"There are some important caveats, however," Dr. LeBlanc said. "First, the average age of menopause is 51, and around this time is when the most acute and severe symptoms usually occur. The average age of women at the start of our study was 64, and by then many of these symptoms could have subsided on their own. To really know if vitamin D can help with the most severe symptoms of menopause, we would need to do a study with younger women."

"Also," she said, "the dose of vitamin D used in this study was fairly low, only 400 international units. It could be that higher doses might be beneficial for menopausal symptoms, but we wouldn't know that without doing a study with a higher dose."

"Menopausal hormone therapy is still the best treatment to relieve menopausal symptoms, and there are studies that show for women who have a low risk for breast cancer and heart disease, short-term (<5 years) low-dose hormone therapy can be a good choice," Dr. LeBlanc explained. "For women who can't or don't want to take hormone therapy, there are other medications that can be tried."

"Simple changes to lifestyle such as lowering room temperature, using fans, dressing in layers of clothing that can be easily shed, and avoiding triggers for hot flashes, can help reduce the number of hot flashes," Dr. LeBlanc said. "There are also options like vaginal estrogen for vaginal atrophy. Women should consult their health care provider to find out what is right for them."

The National Heart, Lung, and Blood Institute funded this research. The authors reported no related disclosures.

SOURCE: https://bit.ly/1dLZUrn

Maturitas 2015.

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