Incontinence is not a disease.  It is a symptom of pelvic floor and/or bladder dysfunction.  The root of this dysfunction may be poor muscle strength or endurance of the pelvic floor.  It may also be altered or blocked transmission of the nerves that communicate with the bladder or pelvic floor muscles.

There are many risk factors that can cause the altered nerve communication or poor pelvic floor muscle function.  They include:  smoking, obesity, pregnancy and childbirth, pelvic/abdominal surgery, neurogenic disease, chronic cough, repetitive heavy lifting, hormone changes, and more.

Researchers continue to discover new risk factors as they study incontinence and prolapse symptoms.  A recent study on vitamin D deficiency showed a relationship between low vitamin D levels and pelvic floor muscle weakness. You can read more details on this study and the recommended levels of vitamin D we should all strive for at

This is one study and I am not one to jump on every new piece of research and take it for fact.  Certainly, there needs to be a follow up, but doesn’t it make you wonder what your Vitamin D levels are?

Published by Tasha


  1. This is very interesting; thanks for bringing up this study. I hadn’t seen that particular one, though I have been following Vit D research out of personal interest for several years. Local to me, the University of California at San Diego has several investigators researching Vit D; the public can view their presentations via UCTV on iTunes. I like to listen to these while I do mundane household tasks or drive in the car.

    For the past two years I’ve made sure everyone in my family (myself, my husband, and my 11 yo old son) gets a 25 (OH)D test at least twice a year (usually late winter/early spring and late summer/early fall) to monitor our Vit D levels and to determine our dose of supplemental Vit D3 (it’s important to get the right test, as too many clueless doctors order the 1,25 (OH)D erroneously, which measures the “active” form of Vit D, not the “storage” form of Vit D, which is like assessing wealth based on a checking account balance rather than on savings and investment balances). My family members take an average daily dose based on 1000iU for each 25 pounds of body weight, which is the general recommendation of Dr. John Cannel of the Vitamin D Council. Our own tests have shown that formula is a good one for us – our tested levels are in a healthy range and we have improved resistance to colds and flu compared to when we didn’t supplement with Vit D. I also noticed I am a stronger skier now – Vit D is closely linked to muscle strength and balance, esp in the elderly. There are some people who may need to adjust that dose formula higher or lower, such as people who eat a LOT of fatty cold water fish on a regular basis probably need less or even no supplemental Vit D (fatty fish are one of the few food sources that is rich in Vit D). Overweight people probably need significantly higher rates of Vit D (Vit D is stored in the body’s fat cells, so more is needed before the 25 (OH)D will rise).

    My gynecologist says that fully 80% of her patients are very low or deficient in Vit D – consider that we are located in the sunny & mild San Diego region, where the conventional wisdom preaches that Vit D deficiency is unlikely, and you start to see the problem that the rest of the country must be having with Vit D deficiency (like the mass of the iceberg under the water surface). In fact, it’s likely that because of the San Diego climate and the emphasis on looking young and avoiding skin sun damage, that many women in this area take extra measures to avoid sun exposure, thereby increasing the risk of Vit D deficiency.

    in other parts of the country the cold and numerous cloudy or air polluted days increases risk of Vit D deficiency. In our hometown in the Northeastern US, my younger sister began suffering from pelvic organ prolapse in her early 30s and eventually had two major surgeries, both of which have failed. The dysfunction has had a major impact on her life. She lives in where there is no Vit D producing sunshine at all from at least Oct-Mar – with similar ave days of sunshine as Seattle, WA. Last year, as my urging, she tested her 25 (OH)D level and found out she was extremely deficient (well below 20 ng/dL on the 25 (OH)D test), as were her two teenage daughters (they are all high SPF sunscreen users during the summer, too, which not only blocks the burning rays, but also blocks the UVB rays that prompt Vit D synthesis in the skin!). So unless they get their Vit D levels up quickly and keep them in a healthy range (with more, but careful, regular sun exposure and fairly high Vit D3 supplementation, my teenage nieces are probably going to go into adulthood with bones that haven’t fully mineralized, with higher risk of various common cancers, and with increased risk of pelvic floor dysfunction (which will be attributed to genetic tendency, no doubt, instead of the more likely Vit D deficiency of their formative years).

    I was diagnosed with pelvic floor prolapse in 2006 when I was 44 yo, but I’m quite sure it began many years before (I made the mistake of having my annual internal exams done by my former internist and she completely missed the prolapse condition until it was quite advanced). I suspect the rectocele condition even began even before my pregnancy in 1998 (my only pregnancy) and was worsened with the violent nighttime coughing fits I often had from sleep apnea (from undiganosed and later undertreated hypothyroidism).

    From testing my own Vit D levels over the past two years, I’m quite sure I was very Vit D deficient during the years when my pelvic prolapse condition was developing. Combine that with years of scrupulous sun avoidance after a skin cancer removal and many puzzle pieces start to fall into place.

    Everyone I know seems to be extremely deficient – my mother who had a 25+ year career as a 3rd shift (night) nurse; my SIL in London, also a nurse who works a rotation on the night shift many times a month; even my tanned friend, who spends much of her recreation time outdoors on weekends, but her tanned skin filters the UVB necessary for skin production of Vit D and she was only taking a very low dose in her multi-vitamin and calcium supplement (only enough to prevent rickets in an infant, not enough for health maintenance in an adult).

    Now I take 5000iU D3 daily on average and have very high resistance to colds and flu (even my skeptical research scientist husband won’t skip his 8000iU Vit D now that he’s observed my well-being on this dose). We keep our 25 (OH)D test results in the upper mid-level (60-80 ng/dL) of the “normal” range of 30-100 ng/dL, as per the recommendation of many of the leading Vit D researchers.

    Bio-identical Vit D3 as cholecalciferol in oil is best (drops or gelcaps) when supplementing, as it is the same molecule as the body makes and recognizes. The D in tablets and multivitamins are often synthetic D2 (ergo-calciferol) which doesn’t absorb as well and must be first converted in the body to be utilized.

    I always take Vit D in the morning or midday (it IS the sunshine vitamin, after-all and is a hormone precursor so I don’t want it to interfere with melatonin production at night). I also always take it with some fat-containing food to enhance absorption (enough fat to stimulate bile salt secretion). Vit D is critically necessary for the absorption of calcium, too. But Vit D fortified milk isn’t enough Vit D for anyone – at only 98 iU Vit D per 8 oz glass of milk, it would take a minimum of 40 glasses daily to equal the amount of Vit D an adult needs to be adequately supplied with Vit D for good long term health (keep in mind the RDA for Vit D is very inadequate – only enough to prevent rickets in an infant) – and low fat and skimmed milk doesn’t have the fat necessary to assure absorption in the small intestine (note my above-mentioned sister and nieces were extremely Vit D deficient, despite all being drinkers of several cups of Vit D fortified skimmed milk daily).

    Magnesium is another co-factor that is often deficient in American. Additionally, fat-soluble Vit K2 intake is also often much too low (K2 puts calcium and other minerals in the teeth and bones where they belong instead of in soft tissue, like the arteries). Vit K2 is found in grass-fed animal fat and organs as well as in the butter fat of cows fed on pasture (not CAFO dairy). Butter and ghee are very rich in K2, which is ironic, since butter and animal fat and organ consumption has gone down as the use of vegetable oil and CVD has gone up (Vit K2 is proving to be protective for CVD, too). Aged raw milk cheese is another good source of Vit K2, which is produced by bacterial fermentation during the cheesemaking process – so eat your cheese – it’s gouda for your bones and teeth ! 😉

    There are lots of recent cutting edge Vit D papers to read on PubMed, but many people find these hard to interpret (not everyone has a biochemist for a spouse like I do, who can help me interpret the studies). Further easier-to-understand information is available on a wide range of Vit D-related topics (an without commercial promotions) at the links below:

  2. Wow, Anna. I respect all your research on this topic. It simply highlights how the medical field continues to progress in its understanding of the human body.

    Thank you for sharing. I’m sure this information will drive others to read further on this topic and to have their Vit. D levels tested as well.


  3. This article was very interesting. I have always been vitamin D deficient and I have bladder prolapse. My vitamin D level was 13 at one point. I often neglect taking the supplement but now I will make sure I start again…just in case.


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