Menopause and how specific vitamins affect health and quality of life

Women in modern society typically live more than a third of their life after menopause. Once they stop menstruating, different hormone changes and ageing processes occur that can potentially affect health and quality of life. Studies show that certain B vitamins, vitamin C, vitamin D, and vitamin K2 affect our mood, cognitive functions, circulatory system, mucous membranes, connective tissues, bones, anti-cancer mechanisms and other functions. It is therefore important to get plenty of these nutrients, especially after menopause where women are particularly vulnerable.

B vitamins

The different B vitamins work as a biological team and control our energy turnover, blood formation, nervous system, hormone system, muscles, and skin and hair. After menopause, women often lack different B vitamins. This can be due to unhealthy and refined diets, poor nutrient absorption, or the use of different types of medicine that disrupt the body’s vitamin B absorption and metabolism. Stress and abuse of alcohol or other substances can deplete the body’s vitamin B stores. To make matters worse, vitamin B12 is only found in animal foods, and the serious symptoms that occur when the liver’s B12 stores have been depleted are insidious.
Several studies have demonstrated that being vitamin B-deficient increases the risk of tiredness, cognitive decline, dementia, and Alzheimer’s disease in post-menopausal women.
In their review article, the authors specifically mention vitamin B12, folic acid, and vitamin B6  that assist the body in breaking down the amino acid homocysteine. This is important because elevated homocysteine levels can cause oxidative stress, burden the circulatory system, and damage nerve cells. Also, elevated homocysteine levels can increase the risk of osteoporosis and bone fractures after menopause.
Meta-analyses have also revealed that supplementing with homocysteine-lowering B vitamins can reduce the risk of stroke by 19-24 percent
Women should therefore make sure to get enough of the different B vitamins after menopause.

• Menopause is not a pause but a word that is derived from the Latin words for month (meno) and for cessation (pausis). It simply means that the monthly bleeding has stopped.

Vitamin C

Vitamin C is important for the body’s production of collagen in connective tissues, and it supports the immune defense, the circulatory system, and promotes wound healing. Studies of post-menopausal women show that the daily intake of vitamin C is positively correlated with bone health and bone density in the lumbar spine, the thigh bone (femur), and the hip.
In other studies of post-menopausal women, vitamin C supplementation has been linked to improved cognitive function assessed by the MMSE scale (Mini-Mental State Examination). Also, it is associated with less accumulation of harmful proteins (beta-amyloid) in the brain, which can set the stage for Alzheimer’s disease.
During a woman’s menopause, she is at increased risk of a rapid left ventricular activity drop, which can be a sign of beginning heart failure. Increased oxidative stress has also been observed. This is when there is an overrepresentation of harmful free radicals that contribute to the left ventricular malfunction. Here, vitamin C is important due to its vital role as a protective antioxidant that counteracts oxidative stress.
It may be a good idea to consider vitamin C supplements with non-acidic forms of ascorbic acid that are gentle on the stomach.

Vitamin D

Most cells in the body have receptors for vitamin D, which is considered a steroid hormone. Lack of vitamin D is very common among menopausal women. First, there is the fact that we do not produce the vitamin in the winter period because the sun is not strong enough. Secondly, it becomes increasingly difficult for women to synthesize vitamin D in the skin and to activate the nutrient in the body in the kidneys and other places after menopause. Finally, problems such as overweight, type 2 diabetes, and the use of sunscreen and cholesterol-lowering medicine also interfere with the body’s ability to synthesize vitamin D.
Studies show that vitamin D supplementation can improve health and quality of life by preventing infections, chronic inflammation, brittle bones, cardiovascular diseases, diabetes, cancer, and neurological disorders. Supplementation with vitamin D is also linked to an increased lifespan.
Still, studies of vitamin D have shown conflicting results for different reasons. If people are not vitamin D-deficient in the first place, supplementation is not likely to make any difference. The same is the case if the supplements used in the trials are of poor quality, contain too little vitamin D, or are not taken long enough to optimize blood levels of the vitamin.
The official guidelines for vitamin D intake are primarily focused on bone health but fail to look at all the other functions of the nutrient. It is therefore important to have optimal blood levels of vitamin D, which should ideally be higher than 75 nmol/L, all year round and throughout life. The European Food Safety Authority (EFSA) has set a safe upper intake level of 100 micrograms of vitamin D daily for adults. Because vitamin D is lipid-soluble, supplements with vitamin D dissolved in oil in capsules give the best result in terms of absorption.

Vitamin K2 (menaquinone)

Vitamin K2 is very important for our circulatory system and bones. It works by activating a protein called matrix GLA that removes excessive calcium from the arteries. Vitamin K2 also activates another protein called osteocalcin that helps embed calcium in the bones for increased bone density. That way, vitamin K2 counteracts atherosclerosis and osteoporosis at the same time. Both conditions are health problems that affect many women after their menopause.
A meta-analysis of menopausal women has shown that supplementation with vitamin K2 improves bone density and lowers the risk of bone fractures.
Vitamin K2 is also important for the formation of other metabolites that can be relevant for heart health.
Vitamin K2 is found in organic meat, eggs, butter and other high-fat dairy products, and fermented foods such as sauerkraut, kefir, and Natto (fermented soybeans). A healthy and well-functioning gut flora can also convert vitamin K1 into vitamin K2. Unhealthy eating habits and prolonged use of blood thinners (vitamin K antagonists such as warfarin), antibiotics, antacids, acetylsalicylic acid, and cholesterol-lowering statins can increase the risk of becoming vitamin K2-deficient.
Guidelines only exist for daily intake of vitamin K1 (75 micrograms), not for vitamin K2. The ability to convert vitamin K1 into vitamin K2 varies a lot from person to person.
According to studies, there does not appear to be any side effects from taking vitamin K2 in doses of 75-180 micrograms daily. Just don’t take vitamin K2 in combination with blood-thinning medication.

References:

Zhaojun Mei et al. The role of vitamin D in menopausal women´s health. Frontiers in Physiology. 2023

Pawel Milart et al. Selected vitamins and quality of life in menopausal women. Menopause Review. 2018

Ming-ling Ma, et al. Efficacy of vitamin K2 in the prevention and treatment of postmenopausal osteoporosis. A systematic review and meta-analysis of randomized trial. Frontiers in Public Health. 2022