Vitamin D: The Midlife Powerhouse for Bone and Pelvic Floor Health
As women move through midlife, two things often start creeping higher on the priority list:
Protecting bone density as estrogen declines
Maintaining pelvic floor function to avoid issues like urinary incontinence or prolapse
What if one nutrient could support both?
Research increasingly points to Vitamin D as more than just a “bone vitamin.” It’s an important player in muscle health—including the pelvic floor—making it worth your attention in midlife and beyond.
Vitamin D and Pelvic Floor Health
Your pelvic floor is a group of muscles and connective tissue that supports your bladder, uterus, and rectum. Like all muscles, it relies on adequate nutrition, including Vitamin D to work properly.
A 2012 review found that Vitamin D helps regulate muscle strength and function, including in the pelvic floor. Women with lower Vitamin D levels were more likely to have urinary incontinence and other pelvic floor symptoms, while those with higher levels tended to have stronger muscle performance. [1]
Population studies have found similar patterns: women with adequate Vitamin D were less likely to report pelvic floor disorders. [2,3] While research is ongoing, this is a modifiable factor you can take action on now.
Vitamin D and Bone Health in Midlife
Vitamin D’s most famous role is in calcium absorption and bone mineralization, which are essential for keeping bones strong.
This becomes especially important in midlife because estrogen decline accelerates bone loss, increasing the risk of osteoporosis and fractures. Without enough Vitamin D, your body can’t use calcium efficiently—even if you’re getting enough from food. [4]
Deficiency is common; up to 80% of menopausal women may not have optimal levels due to reduced sun exposure, less efficient skin conversion, and dietary gaps. [5]
Why This Matters for Both
Bone and pelvic floor health are more connected than they might seem:
Strong bones give your pelvic floor a stable base
Healthy pelvic floor muscles support posture, mobility, and pelvic organ position
Adequate Vitamin D helps both systems work together, supporting confidence and independence in daily life
How to Support Your Vitamin D Levels
Get tested — Ask your provider to check your 25-hydroxyvitamin D levels. Many experts recommend at least 30 ng/mL for optimal health.
Sun exposure — 10–20 minutes, a few times per week, with arms and legs exposed (varies by location, season, and skin tone).
Food sources — Fatty fish (salmon, mackerel, sardines), fortified dairy or plant milks, egg yolks.
Supplement wisely — Most adults benefit from 800–2000 IU daily, but work with your healthcare provider for the right dose and to avoid excess.
The Bottom Line
Vitamin D is a simple, powerful step you can take to support both bone density and pelvic floor strength in midlife. Get your levels checked, make a plan with your provider, and give your body what it needs to stay strong, stable, and confident for years to come.
References
Parker-Autry, C. Y., Burgio, K. L., Richter, H. E. (2012). Vitamin D Status: A Review with Implications for the Pelvic Floor. International Urogynecology Journal, 23(11), 1517–1526. PMC3691097
Badalian, S. S., Rosenbaum, P. F. (2010). Vitamin D and Pelvic Floor Disorders in Women: Results from the National Health and Nutrition Examination Survey. Obstetrics & Gynecology, 115(4), 795–803.
Wehr, E., et al. (2010). Low 25-hydroxyvitamin D is Associated with Urinary Incontinence in Women. American Journal of Obstetrics & Gynecology, 202(6), 556.e1–556.e6.
Holick, M. F. (2007). Vitamin D Deficiency. New England Journal of Medicine, 357(3), 266–281.
Mithal, A., et al. (2009). Global Vitamin D Status and Determinants of Hypovitaminosis D. Osteoporosis International, 20(11), 1807–1820.