Osteoporosis is defined as a thinning and weakening of bone tissue. The statistics regarding osteoporosis and the health problems associated with it are staggering, and it’s one of the most concerning issues facing woman as they enter menopause. Although previously considered a disease that only affects women, osteoporosis has also been recognized as health concern among men. We lose bone density as we age, and as our life expectancy increases, osteoporosis becomes a concern for all of us.
Bones make up the framework within our bodies that supports and protects our organs, but they are not simply static structures. Bones are living tissues that influence our immune system and mineral balance. They have the miraculous ability to remodel after an injury to regain their normal structure. With regards to osteoporosis, we are most concerned about bone strength and its ability to support us. There are several major influences upon bone density and strength. Bones respond to consistent mechanical stimuli, which we experience through exercise and activity. Bones sense the demands upon them and increase their strength accordingly. That is why weight bearing exercise is so important for good bone health. Bones also need an adequate supply of certain minerals, nutrients and various hormones to maintain their strength. Deficiencies or Excess of particular nutrients or hormones can cause weakened bones. For instance, calcium or magnesium deficiencies can lead to low bone density, while high levels of cortisol or parathyroid hormones will tear bones down and weaken them.
Another important influence upon bone health is the Sex Hormones, Estrogen, Progesterone, and Testosterone. Osteoporosis is a huge problem in women as they enter menopause because their sex hormones dramatically decline at this time. Although more gradually, men also experience a decline in sex hormones as they age, and they too are at risk for thinning bones. Osteoporosis caused by estrogen deficiency receives a great deal of publicity, but progesterone and testosterone are not innocent bystanders. All three hormones are needed to maintain healthy, strong bones and deficiencies in any of them will contribute to a loss of bone density. Below I have offered brief explanations of how each sex hormone influences bone health:
ESTROGEN: The effects of estrogen upon bone are complex. However, a little background of bone biology helps to understand its influence. There are two important cell types in bone tissue, osteoblasts and osteoclasts. Osteoblasts produce new bone tissue while osteoclasts remove existing bone tissue. You may wonder why we have cells that tear down our existing bone tissue, but both osteoblasts and osteoclasts are necessary to maintain and repair our bones. They also work together to maintain proper mineral balance in our body. Estrogen is vitally important in regulating osteoblast and osteoclast function and maintains a proper balance of activity between the two cell types. Without adequate estrogen, osteoclast activity can start to overpower osteoblasts, and bones lose their density. Estrogen can prevent loss of bone, but generally, will not help to form new bone.
PROGESTERONE: Progesterone has been shown to stimulate osteoblast function and can potentially stimulate new bone growth. Based on this, you might think that you should use as much progesterone as you can get your hands on. However, the old adage, “too much of a good thing…” applies here. There are studies that suggest when progesterone levels become supra-physiologic or higher than what occurs normally in humans, it can actually inhibit osteoblast function. That is why it’s important to have hormone levels tested regularly and managed by a bio-identical hormone specialist.
TESTOSTERONE: Testosterone also stimulates osteoblast activity and can help bones add strength and density. Testosterone is the dominant male hormone and has a strong influence on bone health in men. However, women have testosterone too, and it is extremely important for maintaining healthy bones in women. Incidentally, a similar situation holds true for men. Men also possess the female dominant hormones, estrogen and progesterone, but they circulate at much lower levels than in women. Still, “female” hormones play a vital role with respect to bone health in men and are needed to prevent osteoporosis.