What Is the Relationship between Estrogen and Osteoporosis?

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  • Written By: Christina Hall
  • Edited By: Lauren Fritsky
  • Last Modified Date: 30 May 2019
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Estrogen and osteoporosis are related in that low estrogen levels are associated with the onset of the disease. Estrogen is a hormone that is required for continued female bone health because it encourages the growth of osteoblasts, the cells that initiate bone growth. As a woman enters peri-menopause and menopause, estrogen levels drop dramatically in the female system; the osteoblasts lose the ability to effectively promote bone growth. In order to treat and prevent osteoporosis, many doctors prescribe supplemental hormones that will address the natural drop in levels, preventing the onset of bone loss.

There are some risks associated with estrogen and osteoporosis treatment. Women who have a recent history of blood clots, liver disease or poor liver function or reproductive cancers are advised to be cautious when beginning a supplemental hormonal regimen. In most cases, progesterone is prescribed in addition to estrogen because the additional hormone has been shown to prevent the development of breast and uterine cancers. Women who have had a hysterectomy do not have to contend with the risk of uterine cancer, however, and can take one hormone for treatment of osteoporosis safely. Estrogen can be administered in pill form or as a patch that is worn on the skin.


There is some debate as to the timing of the drop in significant levels of estrogen and osteoporosis onset. Studies show that the ideal time to start hormone-replacement therapy (HRT) is in peri-menopause. The debate lies in the difficulty of diagnosing the onset of this transition. Often times, doctors and patients rely on the presence of relatively subjective symptoms of estrogen deficiency, like intermittent hot flashes, to determine when the body is ready to begin HRT. Estrogen levels may drop and then climb again to normal levels during peri-menopause, which makes beginning hormonal treatment for osteoporosis a challenge.

While estrogen and osteoporosis are inextricably linked, treating the disease with HRT is not an absolute cure for the disease. While estrogen, taken as prescribed, can halt the disease process, it cannot replace bone loss that has already occurred. Many doctors claim that the most effective way to prevent this initial bone loss it to eat a healthy diet with adequate amounts of calcium and vitamin D. Often times, if the diet is questionable, he or she will recommend an aggressive supplementation regimen as well. This approach is often times encouraged for women who have had low levels of estrogen for their entire adult lives, including those who had a late start to or irregular menstruation.



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