Hormones and bone metabolism

Abstract

Bone metabolism is a complex process that depends on numerous hormones and is dynamically influenced by their effects throughout life. Not only during growth and hormone deficiency phases, but also during the many years of “stable equilibrium” in adulthood, hormonal changes should be considered in case of reduced bone density and, above all, the patient’s existing medication should be requested. Educational work is particularly important in the critical phases of puberty and menopause, when there is great uncertainty among patients and the influence of the prescribed hormone preparations should not be underestimated. Bone metabolism depends on many different hormones. During adolescence growth hormone and estrogen are the key players. Parathyroid hormone, calcitonin, and leptin also play an important role. Hormones directly influence osteoclast and osteoblast function, but also maintain bone density by regulation of vitamin D metabolism and body weight. In the case of hormonal imbalance, patients suffer from bone density loss and, during adolescence, impaired growth. In particular, prior to achieving the peak bone mass and during the menopausal transition, sex hormones are pivotal. Hormonal contraception and menopausal hormone therapy influence bone density and should be prescribed following meticulous evaluation of the hormonal situation.