**5. Conclusions**

Oral vitamin D supplementation, in the form of oral ergocalciferol at 40,000 IU per week for 12 weeks, did not promote a significant difference from the placebo to improve the vaginal health outcomes, including VMI, vaginal pH, and VAS of VVA symptoms in postmenopausal patients with vulvovaginal atrophy. However, vitamin D supplements seemed to improve VMI and vaginal pH both at six and 12 weeks when compared to baseline.

**Author Contributions:** T.K., J.M., S.A.-O.V. and O.V. conceived the hypothesis. T.K. and O.V. conducted the data collection process and prepared the first draft of the manuscript. S.A.-O.V. and A.S. conducted the statistical analyses and provided insights of its clinical significance. T.K., J.M., S.A.-O.V., A.S., and especially O.V. contributed to the final version of the manuscript. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


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