Estrogen signaling in growth plate cartilage

It is well known that sex steroids, in particular estrogens, play an important role in longitudinal bone growth during puberty. High doses of estrogen therapy can reduce the final height of an individual, but such treatment is also associated with severe side effects. At the same time, attenuation of estrogen production by aromatase inhibitors increases adult final height, inhibiting bone turnover, which influences bone architecture and may increase the risk for vertebrae fractures. SERMs, which display either estrogenic and/or antiestrogenic effects, bind to ERs with different affinities and subsequently recruit co-modulators of transcription in a tissue-specific manner.