Dr. Susie Gronski
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Vitamin D Can Help Decrease Risk Of Pelvic Floor Disorders In Women

You may be asking yourself, what does Vitamin D have to do with my lady parts? Vitamin D is one of the oldest hormones on earth and is responsible for maintaining the health of many organ systems in our body, so why not the pelvic floor?

Pelvic Floor 101

Let’s first start by summarizing what the pelvic floor is and how it functions. The pelvic floor is made up of 3 layers of muscle groups that attach from your pubic bone all the way to your tailbone. These muscles have 5 important functions: supports pelvic and abdominal organs, keeps you continent, aids in sexual appreciation like orgasm, functions as a “sump pump” to prevent pelvic congestion and infection, and provides core stability with movement.

The pelvic floor makes up the foundation of your core and plays an intricate role in stabilizing the pressure systems that load your body with functional activities such as laughing, coughing, sneezing, bending, and lifting. Think of your torso as a canister. The front is made up of your abdominal muscles, the back is your spine and all the muscles that support it, the sides are your hip joints and muscles, and the bottom is made up of your pelvic floor muscles. Inside that canister, you have pelvic and abdominal organs that move along with your movements. Even breathing requires assistance from your pelvic floor muscles.

Most importantly, they prevent your organs from falling out! As you can see, the pelvic floor plays an important role in your everyday function.  

There are times when the pelvic floor needs some help. You may start noticing subtle signs of pelvic floor dysfunction such as incontinence with laughing or finding yourself rushing to use the bathroom every 30 minutes. The common misconceptions women have is thinking that symptoms like those are “normal”, “normal after having a baby”, or “normal as you get older”. On the contrary, that isn’t “normal” and usually is a sign that your pelvic floor needs some attention.  It is estimated that “by 2030 one fifth of US women will be over the age of 65 and one third of these women will have at least one pelvic floor disorder. “[2] Pelvic floor disorders include urinary incontinence, fecal incontinence, pelvic pain, and vaginal bulge just to name a few.

Why is Vitamin D so important?

Low Vitamin D levels are very common nowadays. Unless you live in a climate that is sunny most of the year, you may be vitamin D deficient.  Between 1994-2004, vitamin D levels in the US population have dropped by more than 75%. [1] Vitamin D plays an important role in cardiovascular health, bone health, hormone regulation, and inflammation control. More and more research is now suggesting that Vitamin D actually plays a vital role in musculoskeletal health due to a strong relationship with Calcium and its role in muscle function. Vitamin D protects against muscle wasting by influencing muscle cell fibers and cell proliferation.[2]  In women, Vitamin D receptors found in muscles have been shown to decrease with age, which may explain the increasing correlation to pelvic floor disorders. Many studies have already correlated muscle weakness in persons with low Vitamin D levels, which means that insufficient or deficient Vitamin D levels in women can place them at risk for pelvic floor weakness and predispose them to urinary incontinence.

In 2010, a study found in the American College of Obstetricians and Gynecologists, researchers looked at the association between Vitamin D levels and pelvic floor disorders.[3]  Researchers examined data from 1,881 women ages 20 and older.  They found that women who had < 30ng/ml levels of Vitamin D had increased prevalence of urinary and fecal incontinence. There was a 6% decrease in pelvic floor disorders with every 5ng/ml increase in Vitamin D levels. [3] Age and weight were also found to be risk factors contributing to pelvic floor disorders. “Vitamin D-urinary incontinence association was stronger in older women…indicating a 45% reduction in risk of urinary incontinence with vitamin D levels in the normal range.” [3]  

Vitamin D has also shown to help decrease inflammation and reduce pain sensitivity. Research has shown that Vitamin D influences many pain related pathways in the body, which can help decrease pain sensitivity further assisting in effective chronic pain management. [4] A most recent study conducted in the Indian Journal of Clinical Biochemistry found that low vitamin D levels were strongly associated in patients suffering from low back pain.[5]  Although further research for treatment application is required, due to the effects that Vitamin D has on pain pathways, one could presume that Vitamin D can also be beneficial in the management of pelvic pain disorders.

How can you keep your pelvic floor happy and healthy?

Women go through many life stages that change their biochemistry and hormone function, ultimately altering the dynamics of their pelvic floor function.  Pelvic floor physical therapy has proven to be extremely beneficial for women who experience bothersome bladder and bowel symptoms, as well as sexual health dysfunctions such as painful intercourse. Being an integrative physical therapist, I have found that my patients get the most out of their care when also incorporating nutrition, diet, and lifestyle modifications to their plan of care. Your body needs to be nourished for it to function properly. Just like your car, if you neglect changing your oil, the engine will fail!

Increase your vitamin D exposure!

The number one source of Vitamin D is natural SUNLIGHT! How much sunlight exposure varies and depends on your age, region, and climate you live in. For example, in fair-skinned, young individuals, maximum Vitamin D synthesis occurs very rapidly with summer sun exposure.[6] For those who apply sunscreen, it can take a bit longer. For those of us that don’t spend enough time outdoors, there are natural food sources available to bump up your Vitamin D levels. According the National Institute of Health(https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#en11) foods high in Vitamin D₃ include cod liver oil, swordfish, salmon, tuna, orange juice, milk, liver, beef, egg with yolk, and swiss cheese. I’ve even read that shitake mushrooms have a good source of Vitamin D as well! 

Remember that a successful pelvic rehabilitation program depends not only on exercise and manual treatments, but also on what you are feeding your body. Finding a practitioner that understands the importance of caring for your body from the inside out is important.  For more information about participating in a comprehensive pelvic rehabilitation program, please visit us at www.healinghandsdpt.com or call (708) 915-0950.

 


References:

1. Ginde A, Liu M, Camargo C. Demographic Differences and Trends of Vitamin D Insufficiency in the US Population 1988-2004. Arch Intern Med.2009;169(6):626-632.

2. Parker-Autry C, Burgio K, Richter H. Vitamin D Status-A Clinical Review with Implications for the Pelvic Floor.Int Urogynecol J.2012 November;23(11):1517-1526.

3. Badalian S, Rosenbaum P. Vitamin D and Pelvic Floor Disorders In Women: Results From the National Health and Nutrition Examination Survey. American College of Obstetricians and Gynecology. 2010;115(4): 795-803.

4 .Shipton EA, Shipton EE. Vitamin D and Pain: Vitamin D and Its Role In the Aetiology and Maintenance of Chronic Pain States and Associated Comorbidities.Pain and Research Treatment. 2015:1-12.

5. Lodh M, Goswami B, Mahajan RD, Sen D, Jajodia N, Roy A. Assessment of Vitamin D status In Patients of Chronic Low Back Pain of Unknown Etilogy.Indian J Clin Biochem.2015 Apr;30(2):174-179.

6. Wolpowitz D, Gilchrest B. The Vitmain D questions: How much do you need and how should you get it? J AM Acad Dermatol. 2006 Feb;54(2):301-317.


 

The blog content on this website is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.