Influences of Progesterone on Bone Density

Osteoporosis manifests in adulthood, though it truly has its roots in childhood. When children are not given the basic nutrition necessary to achieve their genetic potential, osteoporosis will result. Childhood osteoporosis can be overlooked if fractures go undiagnosed. For example, nearly 80% of pediatric buckle fractures are unreported. Anthropological study reveals inflammatory diseases in Egyptian mummies are also prevalent in the U.S. population. The common thread is large ancient civilizations had a strong reliance upon grains to sustain their populations, like the U.S.

History of Hormones

Even bible stories recount desperate times when Joseph’s brothers traveled to Egypt for grain during a famine. In contrast, small populations eating diets with extremely high mineral concentrations are found to have a little inflammatory disease and the highest rates of healthy 100-year-old individuals. Current facts are echoes of the ancient past; few individuals ingest the 6-8 servings of produce recommended daily. Fresh produce high in mineral concentrations is needed to maintain bone-building physiology, fight inflammation, and reduce disease. Other nutrients, micronutrients, and hormonal balance are necessities for bone formation. Food availability can vary depending on seasonal changes, hormones too, fluctuate through an individual’s life cycle. Both factors are critical to building and maintaining healthy bone density levels. The female menstrual cycle is a monthly fluctuation of sex hormones. Learn more about the influences of progesterone on bone density below.

Progesterone

Progesterone is vital to support egg development and uterine wall thickening. In the case of egg implantation, progesterone supports the pregnancy, and the placenta will produce additional progesterone. If food is scarce, progesterone will influence metabolism to burn available fat stores to improve chances of survival or support a pregnancy. Pregnant or nursing mothers with malnutrition may have signs of bone loss resulting in tooth loss as the mother’s resources are used for the baby’s development. Weight is influenced by hormones in all individuals. Every fat cell in the body produces estrogen which will promote fat deposition and weight gain.

The Glow

The pregnancy “glow” that women commonly have during their second trimester illustrates the youthful effects of progesterone on the skin revealing the anti-inflammatory effects. Progesterone stimulates osteoblasts, and bone cells that cause bone cell growth. A woman is in her best health during the third trimester of pregnancy, preparing her body for delivery and post-partum. After she delivers the placenta, a woman’s progesterone levels drop 400%. “Muscles love progesterone” is a quote by a doctor I’ll never forget. This might explain how a woman’s body can sustain the changes in muscle, posture, and functional strategies pregnancy demands. The nurturing, calm, qualities of a mother are partly how progesterone affects brain function and lifts mood. This supports the bonding of a mother to her infant who will deprive her of sleep, and food, and increase her daily tasks and stresses! She is a feminine goddess.      

Estrogen is the counterbalance to progesterone

Estrogen stimulates growth and cell division. The sexual maturation of a teenage girl is an example. Fat will be deposited on the hips and breasts develop. The added weight gives the young body resources for future pregnancy and improves the chances of survival when food availability is reduced. Estrogen is muscle spasmodic and so stimulates the beginning of menstruation. 

When the menstrual cycle approaches day 1, estrogen levels are greater than progesterone influencing contractions of uterine smooth muscles and loosening of the uterine lining respectively. Women can go through this process with little to no trouble, while others have significant symptoms. Symptoms or conditions associated with estrogen dominance can be insomnia, muscle pain, fibromyalgia, headaches, brain fog, fatigue, constipation, diarrhea, GERD, cancer, and more. There is a long list of estrogen dominant symptoms that women of all ages may experience in or out of fluctuations.  

Estrogen based products

Modern societies’ proliferative use of common products that are exogenous sources of estrogen influences their population’s health. Petroleum products are an example. I have observed how cancer survivors may be instructed to avoid petroleum products, yet when a patient is recovering from a Mohs procedure to remove skin cancer are told to put Vaseline on the scar. Of course, Vaseline’s estrogenic properties are what cause cell growth for speedy healing. But cancer is cell division gone amuck. Many estrogenic products like cosmetic skin and hair products, plastics, and endocrine disruptors like synthetic fragrances are common in manufactured products.

Exogenous sources of a hormone can challenge the ideal balance.  Natural Hormone Balance for Women is a book by Uzzi Reiss, M.D./O.B. GYN with Martin Zucker is a great resource for doctors and patients. It is a thorough book to help women and their M.D.s understand what balance is by learning the expression of the female hormones, and how to test, and interpret them. Balance matters. Since all women’s hormone levels are specific to them, a generalized scale is not available or appropriate for all women to be measured. The most accurate hormone test will measure the free hormone in saliva. 

Imbalanced Estrogen and Progesterone

Symptoms associated with PMS are signs of an exaggerated discrepancy between estrogen and progesterone, resulting in estrogen dominance.
A large prostaglandin swing will increase the inflammatory response resulting in acute discomfort. Bloating, pain, heavy bleeding, headaches, back pain, and mood swings can result. Hormonal shifts post-partum are associated with post-partum depression. Men with postpartum depression have also been found to have the lowest testosterone of new fathers tested. Consider how women are healthiest when their hormones fluctuate, yet the extreme cases of hormone fluctuation result in depression for parents.

Changes over time

Imbalance over time due to a woman’s exposure to estrogens may result in uterine fibroids, polyps, cervical dysplasia, infertility, or cancers. Either a reduction of estrogenic impact or an increased progesterone effect can reduce or resolve PMS symptoms and disease risks. Fortunately, progesterone is protective against cancer and acts as a check against estrogenic effects of tissue growth. Concerning bone density, estrogen stimulates osteoclasts cells. These bone cells are responsible for tearing down old bone cells that are at the end of their life. This opens “real estate” within the bone tissue for new bone cells to grow. Estrogenic osteoporosis treatments have been found to increase bone density by 5%.

There will not be a test on female sex hormones at the end of this blog. Though, I do hope to introduce an understanding of how hormone supplementation may affect women: benefits, side effects, and risks. Hormones affect every cell in the body. The endocrine system has differing feedback methods to reduce hormonal extremes. Down-regulation is when hormone effects are reduced by another hormone. Up-regulation causes an increased intensity of hormone effects by another hormone. For example, a stimulated estrogen receptor will have an estrogenic effect on the body. Similarly, a stimulated progesterone receptor will “turn on” and the progesterone will affect the tissue. However, when the progesterone receptor is turned on it also sends a message to the neighboring estrogen receptor which will “turn down” the estrogenic effects on tissue. The actions will balance each other in all healthy females.

Regulation of hormones

Endocrinology is a complicated specialty. Down and up-regulation is only one simple method of hormone interaction. Progesterone is also an intermediary of thyroid hormone. The thyroid hormone controls our state of consciousness. It impacts metabolism, mood, alertness, sleep, and more. It is very common for women to have a drop in thyroid function after giving birth. This correlates with the drop in progesterone. Thyroid testing is routine post-partum care, though thyroid medication unfortunately is linked with osteoporosis. Progesterone is not thought to be an advantageous post-partum treatment option since it is thought to decrease lactation. However, women who are not lactating and take thyroid medication currently can take progesterone for bone-building benefits. Progesterone supplementation should be followed closely with thyroid level testing since the dose of thyroid medication will likely need to be reduced.

Many women enjoy progesterone supplementation benefits

Increased energy and mental clarity while reducing acne and wrinkling. Women with cystic breast tissue can see a return of normal breast tissue and breast fullness improving result accuracy of mammograms. Reduced body fat and improved muscle tone and function are common.
Menstruating women with dysmenorrhea may have reduced flow, clotting, or other PMS symptoms.

Many patients I have encountered have difficulty finding osteoporosis treatment approaches that are right for them. The body has a continual process of building new bone cells and tearing down old bone cells. It is this process that medications often impact. The most common medications have a hormonal approach such as the synthetic estrogens that slow the effects of the body’s osteoclasts. The osteoclast cells recognize old bone cells and remove them at the proper time. Cells of the body do have a lifespan and will be torn down to make room for new cells to form. As a result of more old bone cells remaining in bone, the density of bone will increase.

Treatment

Natural bioidentical hormone replacement is a hormonal treatment option for osteoporosis and many conditions noted above. This approach is supported by a variety of practitioners: MDs, LPNs, Homeopaths, Naturopaths, and Doctors of Functional Medicine. Many women fear these hormones expecting them to have the same strong/exaggerated effects and unpleasant side effects as synthetic hormones. The natural, bioidentical hormones are different from the chemically derived hormones; they are the exact molecular configuration as our human female hormones and have been used safely since the 1970s. As a result, they do not have the same strong, unpleasant side effects. The safe range of progesterone is large. A woman makes 25mg of progesterone a day, while during pregnancy she will make 400mg a day. Keep in mind many women have symptoms of imbalance during their life, and correct supplementation can assist the body to regain balance, achieve homeostasis, normal behavior, and function.

Progesterone

Progesterone is the female sex hormone that does balance estrogen. It stimulates the bone-building cells called osteoblasts. New bone cells will replace old, dead cells. This is another bioidentical natural hormone replacement method for increasing bone density. It is an important intermediary for the formation of other hormones influencing many processes regarding stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Media advertisements for bioidentical hormones will never be seen since there are no big profits to be made. They occur naturally and can have no patent. Bioidenticals can be affordable and bought over the counter or conveniently online. Compounding pharmacies often work with physicians who are well versed with saliva testing and can be a good resource to a patient seeking a provider. Progesterone is most efficiently absorbed through the skin and delivered through a cream.

Find osteoporosis-related classes I teach in Whitefish Bay, Nicolet, and Mequon Park and Recreation catalogs.