Effectiveness of two doses of vitamin D3 in women with vitamin d deficiency and hypoactive sexual desire disorder: a randomized clinical trial

Efectividad de dos dosis de vitamina D3 en déficit de vitamina D, en mujeres con deseo sexual hipoactivo. Ensayo clínico aleatorizado

Introduction: hypoactive sexual desire disorder (HSDD) etiologies are usually complex and multifactorial. One of the leading endocrine causes is Vitamin D3 deficiency. Objective: to evaluate the effectiveness of vitamin D3 therapy in women with vitamin D deficiency and HSDD and identify its adverse effects. Materials and methods: a triple-blinded, randomized clinical trial, in 92 ˃ 18 and < 40 years women, with 25(OH)D levels < 30 ng/mL, conducted in the coffee region of Colombia, between 2016 and 2019. Patients were randomized into two groups. Group «A» included 45 women who received 50.000 IU and «B» included 47 women who received 14.000 IU of vitamin D3. Follow-up visits were carried out at one, two and three-months. The “Female Sexual Function Index” (FSFI) instrument was applied, using a descriptive analysis. Results: mean age was 35.99 ± 5.32 years. By the end of the study 25 (OH)D levels increased in both groups («A»: 53.72 ± 8.41 vs. «B» 36.28 ± 4.57; p=0.001). The FSFI score revealed significant differences («A»: 27.87 vs. «B»: 26.81; p=0.048), observing improvement of HSDD in 84.44% in group «A» vs 38.29% in group «B» (p<0.05). Weekly frequency of sexual activity increased («A» 4 vs. «B» 2; p<0.05). The adverse effects were mild. Conclusions: vitamin D3 is a therapeutic option in women with HSDD. Similar studies applying the evaluation schemes in larger groups need to be performed elsewhere in the country, to better understand the effects of this therapy.

1. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153-165. doi:10.1007/s11154-017-9424-1
2. Srivastava SB. Vitamin D: Do We Need More Than Sunshine?. Am J Lifestyle Med. 2021;15(4):397-401. Published 2021 Apr 3. doi:10.1177/15598276211005689
3. Roth DE, Abrams SA, Aloia J, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci. 2018;1430(1):44-79. doi:10.1111/nyas.13968
4. Espitia De La Hoz FJ, Orozco Santiago L. Prevalencia del déficit de vitamina D en mujeres posmenopáusicas de Armenia. Revista Colombiana de Endocrinología, Diabetes & Metabolismo. 2019; 6(3):171-6.
5. Espitia De La Hoz FJ, Orozco Santiago L. Prevalencia del déficit de vitamina D y de los factores de riesgo asociados, en gestantes del Quindío. Revista Colombiana de Endocrinología, Diabetes & Metabolismo. 2018; 5(4):5-12.
6. Espitia De La Hoz FJ. Déficit de vitamina D en hombres y mujeres con deseo sexual hipoactivo: Estudio de prevalencia. Rev. Méd. Risaralda 2020; 26(2):123-9. doi: 10.22517/25395203.23251
7. Chauhan K, Shahrokhi M, Huecker MR. Vitamin D. 2021 Aug 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.
8. Pfotenhauer KM, Shubrook JH. Vitamin D Deficiency, Its Role in Health and Disease, and Current Supplementation Recommendations. J Am Osteopath Assoc. 2017;117(5):301-305. doi:10.7556/jaoa.2017.055
9. Podzolkov VI, Pokrovskaya AE, Panasenko OI. Vitamin D deficiency and cardiovascular pathology. Ter Arkh. 2018;90(9):144-150. doi:10.26442/terarkh2018909144-150
10. Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nat Rev Endocrinol. 2022 Feb;18(2):96-110. doi: 10.1038/s41574-021-00593-z
11. Pettigrew JA, Novick AM. Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment. J Midwifery Womens Health. 2021;66(6):740-748. doi:10.1111/jmwh.13283
12. Derogatis LR, Revicki DA, Clayton AH. Instruments for Screening, Diagnosis, and Management of Patients with Generalized Acquired Hypoactive Sexual Desire Disorder. J Womens Health (Larchmt). 2020;29(6):806-814. doi:10.1089/jwh.2019.7917
13. Velten J, Hirschfeld G, Meyers M, Margraf J. Psychometric Properties of a Self-Report Version of the Sexual Interest and Desire Inventory-Female (SIDI-F-SR). J Sex Med. 2021;18(5):990-995. doi:10.1016/j.jsxm.2021.03.001
14. Dall'Agno ML, Ferreira CF, Ferreira FV, Pérez-López FR, Wender MCO. Validation of the Six-item Female Sexual Function Index in Middle-Aged Brazilian Women. Validação do índice de funcionamento sexual feminino-6 em mulheres brasileiras de meia-idade. Rev Bras Ginecol Obstet. 2019;41(7):432-439. doi:10.1055/s-0039-1692694
15. Espitia De La Hoz FJ. Prevalence and characterisation of sexual dysfunctions in women, in 12 Colombian cities, 2009-2016. Rev Colomb Obstet Ginecol 2018; 69(1):9-21. doi: 10.18597/rcog.3035
16. Vaughan M, Trott M, Sapkota R, et al. Changes in 25-hydroxyvitamin D levels post-vitamin D supplementation in people of Black and Asian ethnicities and its implications during COVID-19 pandemic: A systematic review [published online ahead of print, 2021 Oct 6]. J Hum Nutr Diet. 2021;10.1111/jhn.12949. doi:10.1111/jhn.12949
17. Avataneo V, Palermiti A, De Nicolò A, et al. Monthly Increase in Vitamin D Levels upon Supplementation with 2000 IU/Day in Healthy Volunteers: Result from "Integriamoci", a Pilot Pharmacokinetic Study. Molecules. 2022;27(3):1042. Published 2022 Feb 3. doi:10.3390/molecules27031042
18. Wise SA, Camara JE, Burdette CQ, et al. Interlaboratory comparison of 25-hydroxyvitamin D assays: Vitamin D Standardization Program (VDSP) Intercomparison Study 2 - Part 1 liquid chromatography - tandem mass spectrometry (LC-MS/MS) assays - impact of 3-epi-25-hydroxyvitamin D3 on assay performance. Anal Bioanal Chem. 2022;414(1):333-349. doi:10.1007/s00216-021-03576-1
19. Hock M, Farkas N, Tiringer I, Gitta S, Németh Z, Farkas B. Validation and translation of the Hungarian version of the Female Sexual Function Index (FSFI-H). Int Urogynecol J. 2019;30(12):2109-2120. doi:10.1007/s00192-019-04049-x
20. Pietras SM, Obayan BK, Cai MH, Holick MF. Vitamin D2 treatment for vitamin D deficiency and insufficiency for up to 6 years. Arch Intern Med. 2009 Oct 26;169(19):1806-8. doi: 10.1001/archinternmed.2009.361
21. Canat M, Canat L, Öztürk FY, Eroğlu H, Atalay HA, Altuntaş Y. Vitamin D3 deficiency is associated with female sexual dysfunction in premenopausal women. Int Urol Nephrol. 2016 Nov;48(11):1789-1795. doi: 10.1007/s11255-016-1396-7
22. Askin M, Koc EM, Soyoz M, Aksun S, Aydogmus S, Sozmen K. Relationship between Postmenopausal Vitamin D Level, Menopausal Symptoms and Sexual Functions. J Coll Physicians Surg Pak. 2019;29(9):823-827. doi:10.29271/jcpsp.2019.09.823
23. Bacanakgil BH, İlhan G, Ohanoğlu K. Effects of vitamin D supplementation on ovarian reserve markers in infertile women with diminished ovarian reserve. Medicine (Baltimore). 2022;101(6):e28796. doi:10.1097/MD.0000000000028796
24. Jalali-Chimeh F, Gholamrezaei A, Vafa M, Nasiri M, Abiri B, Darooneh T, Ozgoli G. Effect of Vitamin D Therapy on Sexual Function in Women with Sexual Dysfunction and Vitamin D Deficiency: A Randomized, Double-Blind, Placebo Controlled Clinical Trial. J Urol. 2019 May;201(5):987-993. doi: 10.1016/j.juro.2018.10.019
25. Krysiak R, Gilowska M, Okopień B. Sexual function and depressive symptoms in young women with low vitamin D status: a pilot study. Eur J Obstet Gynecol Reprod Biol. 2016 Sep;204:108-12. doi: 10.1016/j.ejogrb.2016.08.001
26. Galior K, Grebe S, Singh R. Development of Vitamin D Toxicity from Overcorrection of Vitamin D Deficiency: A Review of Case Reports. Nutrients. 2018;10(8):953. Published 2018 Jul 24. doi:10.3390/nu10080953