Der Einfluss der Gestagene auf die Knochengesundheit

Progesterone and synthetic progestins are able to influence the endometrium but also have a number of other nongenomic and genomic mechanisms, many of which are the topic of current research. While high-dose medroxyprogesterone acetate (depot progestin) is associated with decreased bone formation, low-dose progestins (daily administration) also have a positive—especially anabolic—effect on bone that may add to the antiresorptive effects of estrogen. Already during perimenopause and thus before the estrogen deficits of menopause/postmenopause, there is a marked decrease in bone density. Some women lose 50% of their total trabecular bone during perimenopause. Several studies have shown an association with luteal phase disturbances, which are associated with a relative progesterone deficit. In climacteric disorders, the addition of progesterone or a specifically selected synthetic progestin to estrogen could contribute further to preventing osteoporosis.