Estrogen and osteoporosis: How hormones influence bone health


In this article:

  • Estrogen helps support many different body functions, from sexual health to bone health.

  • Estrogen levels can decline as women age, which can lead to weaker bones and even osteoporosis.

  • A well-balanced diet, regular exercise, and a healthy lifestyle can help improve your bone health.

When you think of estrogen, you probably first think of its impact on reproductive and sexual health. But did you know estrogen can also play an important role in your bone health?

“Estrogen is a powerhouse hormone that supports the development and function of many different areas of our how bodies function,” shares Melanie Santos, MD, FACOG, FPMRS, medical director of pelvic health for St. Jude Medical Center in Fullerton, California. “One of those functions is to regulate our bone’s metabolism – the constant making and breaking down of bone tissue.” 

As women begin to produce lower levels of estrogen as they age – and all together stop during menopause – they become at higher risk of developing osteoporosis, which is a condition that causes bones to become weak and brittle.

Fortunately, there are many steps women of any age can take to support bone health before it becomes a concern. The first step is understanding the connection between estrogen and bones. 

Estrogen’s role in healthy bones

Our skeleton completely regenerates about every 10 years thanks to bone metabolism. While the nutrients and minerals you’d expect play a starring role in the process (calcium, magnesium, vitamins D, K, and A – just to name a few), estrogen is also a key driver of this critical chain of events.

Estrogen has a direct influence on bone cells, including osteocytes, osteoblasts and osteoclasts. These cells are responsible for creating new bone tissue and reabsorbing old bone tissue.

“Estrogen helps keep a fine balance between how much bone tissue our bodies are making and how much is being reabsorbed,” explains Dr. Santos. “When our bodies make less estrogen, they can’t make as many bone-building cells. That means we are reabsorbing more bone tissue than we are replacing, which leads to weaker and more brittle bones.”

Bone density and osteoporosis

Bone density is a common term used to measure how much bone tissue you’ve lost due to natural aging or other conditions. If you lose too much bone density or your doctor notes other specific changes to the structure of bone tissue, you may be diagnosed with osteoporosis.

Osteoporosis is a bone disease that leads to an increased risk of fractures. Not everyone who goes through menopause will develop osteoporosis. It’s also important to remember that menopause isn’t the only cause of osteoporosis. Other risk factors of osteoporosis include:

  • Body size
  • Race
  • Family history
  • Diet
  • Lack of physical activity
  • Heavy drinking
  • Smoking
  • Medical conditions, including:
    1. Rheumatoid arthritis
    2. HIV/AIDS
    3. Anorexia nervosa
    4. Endocrine and hormonal diseases
    5. Gastrointestinal diseases
  • Certain types of cancer
  • Long-term medications, such as:
    1. Glucocorticoids and adrenocorticotropic hormones
    2. Antiepileptic medication
    3. Cancer medications
    4. Proton pump inhibitors
    5. Selective serotonin reuptake inhibitors (SSRIs)
    6. Thiazolidinediones

Bone health at every age

Fortunately, there are many steps you can take at any age to help protect your bone health. Whether you’re 30 or 60, here are some simple tips you can keep in mind to keep your bones strong and flexible.

Get plenty of calcium and vitamin D

Calcium and vitamin D are a great team to help improve your bone health. Calcium helps build and maintain bones, while vitamin D helps decrease bone loss. Vitamin D also helps your body absorb calcium. Your doctor can discuss how much calcium and vitamin D you need, and if you need a supplement.

Here are also a few great sources of vitamin D and calcium:

  • Egg yolks
  • Saltwater fish
  • Liver
  • Milk (with vitamin D)
  • Green leafy vegetables
  • Beans and legumes
  • Nuts and almonds

Stay active

You can help improve your bone strength with regular exercise that focuses on strength-building and weight-bearing workouts. Need a few ideas? Here are some simple exercises to get you started:

  • Walking
  • Lifting weights
  • Yoga
  • Dancing
  • Swimming
  • Biking

Put a priority on your good health

Healthy choices – including getting plenty of calcium and vitamin D and exercising regularly – are just the tip of the iceberg for protecting your bone health. Here are small steps that can add up to a big difference:

  • Don’t smoke
  • Drink in moderation
  • Eat a well-balanced diet with plenty of fruit and vegetables
  • See your primary care doctor regularly

“Annual wellness visits and check-ins with your doctor can help identify and address any risk factors or concerns you or your doctor have about your bone health,” shares Dr. Santos. “Please, don’t hesitate to share any questions you may have about protecting and strengthening your bone health – at any age.”

Be proactive

It’s easier to break a bone – and harder for it to heal – when bones become weak. Take steps now to reduce your risk of falls so you can stay healthy, strong, and on the go.

  • Remove trip hazards like loose rugs, boxes, cords, or items in your path.
  • Keep lights turned on to help you see your surroundings more clearly. 
  • Get your vision checked at least once a year.
  • Strengthen your balance with classes like Tai Chi, yoga, or by walking every day.


Find a doctor

If need to find a doctor, you can use our provider directory. Through Providence Express Care Virtual, you can also access a full range of health care services.

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Related resources

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

About the Author

The Providence Women's Health team is committed to providing useful and actionable insights, tips and advice to ensure women of all types can live their healthiest lives.

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