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Osteoporosis and Hormones

Too much or too little of certain hormones in the body can contribute to osteopenia and osteoporosis.

  • During and after menopause, the ovaries make much less of the hormone estrogen. Estrogen loss may also occur with surgical removal of the ovaries or because of excessive dieting and exercise. Estrogen helps protect bone.
  • Men produce less testosterone as they age.  Lower testosterone levels may also contribute to bone loss.
  • Bone loss can result from the damaging effects of excess cortisol, as occurs in Cushing’s syndrome.  Sometimes the body produces excess cortisol because of a pituitary or adrenal gland tumor or other rare tumors. More commonly, Cushing's syndrome develops as a result of long-term use of corticosteroid medications (steroids) such as prednisone and cortisone, used to treat inflammatory disorders such as rheumatoid arthritis and asthma.
  • Other hormone imbalances that may increase the risk of osteoporosis include an overactive thyroid gland, too much parathyroid hormone due to a growth in one or more parathyroid glands,  diabetes, and hyperprolactinemia, in which the pituitary gland produces too much of the hormone prolactin..
  • Thyroid cancer survivors whose treatment includes high doses of thyroid hormone also have a higher risk, as do patients with hypothyroidism (an underactive thyroid gland) who receive excessive doses of thyroid hormone replacement.
  • Eating disorders, especially anorexia nervosa, increase the risk of osteoporosis. Bone loss occurs partly because of poor nutrition and partly because of lowered sex hormone production. 

Editors:

Jens Bollerslev, MD
Rikshospitalet Medical Clinic

Steven T. Harris, MD
UC San Francisco

Dolores Shoback, MD
UC San Francisco/VA Medical Cente

Last Review: May 2013