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How does estrogen affect osteoporosis? | BY HEIDI


 

Estrogen plays an important role in maintaining bone structure. Having low estrogen levels can lead to porous, weakened bones and osteoporosis.


Our bones are made of living, growing tissue. The body is constantly breaking down old bone and growing new bone to take its place.


When a person has osteoporosis, their body makes too little new bone, loses too much bone, or both.


Menopause is a natural process, and it causes levels of certain hormones, including estrogen, to decrease. This can lead to osteoporosis.


Below, learn how estrogen influences osteoporosis, how to prevent the condition, and what the treatments entail.


How does estrogen help with osteoporosis?


When estrogen levels drop — for example, during menopause — a person may lose bone density. This makes their bones fragile and brittle, increasing the risk of fractures.


Low estrogen levels and osteoporosis

Bones are made up of a matrix of proteins and minerals, making them both strong and flexible. They contain osteocytes, which are special cells that maintain this matrix.



Experts do not understand exactly how estrogen affects bone, but they believe that the complex relationship between the two involves:


The immune system: Scientists think that estrogen affects bone homeostasis by regulating the immune system.

Effects on bone cells: Estrogen affects bone cells, including osteocytes, osteoblasts, and osteoclasts.

Oxidative stress: An imbalance between free radicals and antioxidants can cause oxidative stress.

Sema3A protein: There may be a relationship between estrogen and the sema3A protein in osteocytes. As people age, their levels of estrogen and sema3A deplete, which leaves the bones unable to maintain their structure.


Preventing osteoporosis

There are various ways to prevent bone loss, including:


eating foods rich in calcium and vitamin D

taking calcium and vitamin D supplements

regularly doing weight-bearing exercises, such as walking, jogging, skipping rope

doing resistance exercise, such as weight training or push-ups

avoiding smoking and excessive alcohol consumption

absorbing vitamin D through small amounts of sun exposure

Estrogen replacement therapy



ERT can come as a pill or skin patch. A doctor may suggest taking a pill daily or using a skin patch twice weekly. The treatment may also involve taking the hormone progesterone.


Risks and considerations

ERT was once the only approved osteoporosis treatment. However, doctors do not use it widely for this purpose anymore. This is because scientists and health experts have linked ERT with an increased risk of:


breast cancer

heart attack

uterine cancer

mental decline

stroke

blood clots

ERT can protect people from bone loss after menopause. If a doctor suggests this treatment, they will likely recommend the lowest effective dosage for the shortest amount of time.


Contacting a doctor

Osteoporosis does not typically cause symptoms, and a person may not realize that they have it until they fracture a bone.


To detect bone loss early, the National Osteoporosis Foundation recommends contacting a doctor about a bone density test. This applies to people who:


have chronic back pain

are going through menopause

are over 50 years old and have fractured or broken a bone

are female and over 65 years old

are a male and over 70 years old

have lost more than half an inch of height in 1 year

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