From sex hormones to stress hormones – we explore how your hormones could be affecting your bone health.
Hormones have a direct impact on your bone health and play a crucial role in maintaining bone mass and bone mineral density.
If your hormone levels change, you may be more at risk of developing osteoporosis, or other bone-related diseases.
Read on to learn more about the hormones that could be impacting your bone health.
Oestrogen is one of the most important female sex hormones, and it is responsible for the regulation and development of the female reproductive system. However, what is less commonly understood, is the crucial role oestrogen plays in maintaining healthy bones.
Our bones are constantly regenerating throughout our lives; they are broken down by osteoclast cells, while osteoblast cells build new bone to replace it. For women, oestrogen plays a key part in this bone remodeling process.
Oestrogen supports the osteoblast cells, promoting their activity so more bone can be produced. Additionally, oestrogen further limits the rate at which osteoclasts break down old bone, helping to maintain existing bone mass.¹
However, if oestrogen levels decrease, such as during menopause, these hormones can no longer effectively support the bone remodeling process. Bone mass and bone mineral density decrease as a result, increasing the risk of osteoporosis.
Calcium is crucial for bone health, and oestrogen supports the absorption of calcium into the body.² This means if oestrogen levels are low, even if you are consuming the right amount of calcium in your diet, your body won’t be able to absorb it efficiently. With 99% of the body’s calcium stored in the bones, bone mass and bone mineral density will inevitably decrease when oestrogen levels are low.
During perimenopause, the natural transition period before menopause, oestrogen levels start to decrease. This is usually indicated by menstrual irregularity. Most women start to notice changes in their 40’s, however, all women all enter perimenopause at different ages. Many women will begin losing a small amount of bone mass and density at this stage.
Following menopause, oestrogen levels significantly decrease, and bone loss speeds up. Women can lose up to 10-20% of their total bone mass in the first five to six years around menopause.³ Menopause occurs at different ages for everyone, but typically begins between 45 and 55.
Some women can experience early menopause, under the age of 45. With oestrogen levels decreasing earlier in life, women going through an early menopause will start losing bone mass and bone mineral density at a younger age.
Women with Premature Ovarian Insufficiency (POI) have lower levels of oestrogen and are also at greater risk of developing osteoporosis.⁴
Due to changes in hormone levels, women are generally considered more at risk of developing osteoporosis than men. In the UK, 50% of women over 50 are affected by osteoporosis, in comparison to 20% of men.⁵
By binding to receptors on the osteoblast cells, progesterone promotes bone-building activity, replacing old, dead bone cells with new, healthy ones.⁶ Hand in hand with oestrogen, progesterone plays an important role in the maintenance of healthy bone mass and mineral density.
However, like oestrogen, progesterone levels fall during menopause. Bone-building activity slows down as a result, causing an imbalanced bone remodeling process, where more bone is being broken down than formed.
Whilst menopause may be inevitable, osteoporosis is preventable. There are lots of treatment options available which can help reduce hormone-related bone loss.
Hormone replacement therapy (HRT) is a commonly used, effective treatment for osteoporosis in postmenopausal women. By mimicking the effects of oestrogen and progesterone, HRT can quickly normalize bone turnover, increasing osteoblast activity. When prescribed correctly, HRT is effective at preserving bone mass and density, while simultaneously treating other menopause symptoms.⁷ Make sure to talk with GP if you are interested in HRT.
Low-intensity vibration therapy has been studied for 35 years and has been shown to increase bone mineral density and prevent osteoporosis for postmenopausal women.⁸
By sending precisely calibrated signals through your bones, devices such as the Marodyne LiV activate the cells in your bones to regenerate. This helps encourage bone growth, countering the effects of oestrogen and other hormone deficiencies.
The impact a healthy lifestyle can have on your hormones and your bone health should not be underestimated. While menopause is an inevitable part of life, osteoporosis is not! There are lots of small lifestyle changes you can make to reduce your risk of osteoporosis, despite changing hormone levels.
Balanced diet: Eating a varied diet, rich in nutrients such as calcium, vitamin D and protein will significantly benefit your bone health. The Royal Osteoporosis Society provide some great tips for eating well for your bones in their guide to nutrition for bones.
Exercise: Regular exercise helps slow the rate of bone loss and increase overall bone strength. Weightbearing exercises are particularly beneficial for your bones. Even going for walk a day once a day can do wonders for your bone health!
Alcohol consumption and smoking: Excessive alcohol consumption and smoking can result in further hormone deficiencies and impact the way your body absorbs critical minerals.
Testosterone is the main male sex hormone, produced in the testicles. Testosterone is a very important hormone for bone health in men, playing an important role in maintaining bone mineral density and mass.
Much like sex hormones in women, testosterone benefits the bone remodeling process in men – promoting bone formation (osteoblasts), and inhibiting bone resorption (osteoclasts).
Testosterone deficiency is associated with bone loss and decreased bone mineral density. With age, men experience a gradual decline in their hormones. Testosterone levels decrease by roughly 1% per year from around the age of 40.⁹
Studies have also shown that testosterone levels in women can affect their bone health in similar ways. With higher testosterone levels leading to higher bone mass for women.¹⁰
Testosterone replacement therapy (TRT) has been shown to be useful in increasing bone mineral density for men who have lower levels of testosterone. Studies have even shown bone density to return to normal after continued use of TRT.¹¹
Speak to your GP to discuss whether TRT would be a good option for you.
Low-intensity vibration therapy can help increase your bone mass and bone mineral density in just 10 minutes per day and can be used alongside treatments such as TRT.
Thyroxine is a hormone released from the thyroid gland, which is responsible for regulating the rate of bone replacement.
Normal levels of thyroid hormones such as thyroxine, are required for optimum bone mass and strength. If levels of thyroxine become too high or too low, the bone remodeling process becomes unbalanced.
Hyperthyroidism, often called an overactive thyroid, happens when the thyroid gland produces too much thyroxine. This accelerates the rate of bone loss – osteoclasts break down old bone quicker than osteoblasts can replace it with new bone.
This condition can result in decreased bone mass and bone mineral density.
Hypothyroidism is the opposite of hyperthyroidism, whereby the thyroid is underactive, and doesn’t produce enough thyroxine.
An underactive thyroid is not a risk factor for osteoporosis in the same way an overactive thyroid is. However, treatments such as levothyroxine, which work by increasing thyroxine levels, must be monitored. If they increase thyroxine levels by too much, then osteoporosis can become a potential risk factor.¹²
Calcium is a critical mineral for bone health and is a major provider of strength and bone mineral density. Calcium levels in the bones are maintained and stabilized by some of the following calcium-regulating hormones:
Parathyroid hormones regulate calcium levels in the bloodstream to ensure there are sufficient levels of calcium in the body.
Calcitriol is a hormone produced from vitamin D and is necessary for calcium absorption in the intestines.
Low levels of calcitriol are commonly associated with poor bone health and osteoporosis. This hormone can be prescribed as medication for individuals who do not produce enough naturally.¹³
Calcitonin is a hormone responsible for inhibiting bone resorption. Opposite to parathyroid hormones, calcitonin hormones ensure calcium levels in the body don’t get too high.
Although it may seem strange, stress can be harmful to your bones!
Cortisol is a hormone produced in the adrenal glands, responsible for helping the body withstand stress.
If cortisol levels get too high, especially in the elderly, this can result in increased osteoclast activity (bone resorption) and decreased osteoblast activity (bone-building).
Alongside improving your bone health, lower cortisol levels can have many other health benefits, including controlled blood sugar levels and blood pressure. Fortunately, there are many ways you can naturally reduce your cortisol levels:
Looking after your mental wellbeing: High stress levels are generally correlated with lower mental wellbeing. From meditation, to journaling, anything you can do to benefit your mental wellbeing will help reduce your cortisol levels.
Eat a healthy, nutritious diet: Excessive sugar and processed foods will raise cortisol levels. Maintaining a healthy diet rich in vitamins and minerals will help control your cortisol levels, and make you feel overall much better!
Reduce your caffeine intake: Stress is often heightened by caffeine, so monitoring your caffeine intake will help naturally reduce your cortisol levels. Reduced caffeine intake will also help you get better quality sleep – inadequate sleep will increase levels of cortisol in the bloodstream.
Exercise: Gentle, low-impact exercise will help lower cortisol levels, relieving stress and improving your overall health and wellbeing.
1. Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrinol Metab. 2012 Nov;23(11):576-81. doi: 10.1016/j.tem.2012.03.008. Epub 2012 May 16. PMID: 22595550; PMCID: PMC3424385. 1016/j.tem.2012.03.008
2. McIlroy J, Dryburgh F, Hinnie J, Dargie R, Al-Rawi A. Oestrogen and calcium homeostasis in women with hypoparathyroidism. BMJ. 1999 Nov 6;319(7219):1252-3. doi: 10.1136/bmj.319.7219.1252. PMID: 10550094; PMCID: PMC1117023. 1136/bmj.319.7219.1252
3. Ji, Meng-Xia, and Qi Yu. “Primary osteoporosis in postmenopausal women.” Chronic diseases and translational medicine 1,1 9-13. 21 Mar. 2015, doi:10.1016/j.cdtm.2015.02.006
4. Szeliga, A., Maciejewska-Jeske, M., & Męczekalski, B. (2018). Bone health and evaluation of bone mineral density in patients with premature ovarian insufficiency. Menopause Review/Przegląd Menopauzalny, 17(3), 112-116. 5114/pm.2018.78552
5. Royal Osteoporosis Society. (2023). International Women’s Day: Let’s end the ageist stereotypes that fuel the most insidious women’s health condition. https://theros.org.uk/latest-news/international-women-s-day-let-s-end-the-ageist-stereotypes-that-fuel-the-most-insidious-women-s-health-condition/
6. https://womeninbalance.org/resources-research/progesterone-bone-health/
7. Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014 Sep;13(4):213-20. doi: 10.5114/pm.2014.44996. Epub 2014 Sep 9. PMID: 26327857; PMCID: PMC4520366. 5114/pm.2014.44996
8. Rubin, C., Recker, R., Cullen, D., Ryaby, J., McCabe, J., & McLeod, K. (2004). Prevention of postmenopausal bone loss by a low‐magnitude, high‐frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. Journal of Bone and Mineral Research, 19(3), 343-351. https://doi.org/10.1359/JBMR.0301251
9. Shigehara K, Izumi K, Kadono Y, Mizokami A. Testosterone and Bone Health in Men: A Narrative Review. Journal of Clinical Medicine. 2021; 10(3):530. https://doi.org/10.3390/jcm10030530
10. Zhang, H., Ma, K., Li, R. M., Li, J. N., Gao, S. F., & Ma, L. N. (2022). Association between testosterone levels and bone mineral density in females aged 40–60 years from NHANES 2011–2016. Scientific Reports, 12(1), 16426. https://doi.org/10.1038/s41598-022-21008-7
11. Behre, H. M., Kliesch, S., Leifke, E., Link, T. M., & Nieschlag, E. (1997). Long-term effect of testosterone therapy on bone mineral density in hypogonadal men. The Journal of Clinical Endocrinology & Metabolism, 82(8), 2386-2390. https://doi.org/10.1210/jcem.82.8.4163
12. https://www.btf-thyroid.org/thyroid-disorders-and-osteoporosis
13. https://parathyroiduk.org/living-with-hypopara/self-help-guide/understanding-your-medication/
Over 35 years of scientific research have shown the benefits of Low-intensity Vibration therapy for your bone health.
Marodyne LiV is certified to help stimulate new bone production and combat osteoporosis.
