Calcium metabolism in postpartum lactation: the effect of estrogen status

Postpartum lactation represents a unique state of increased calcium demand in which women are also hyperprolactinemic and hypoestrogenic. This is associated with increased calcium mobilization from bone and bone loss. To better understand the effect of estrogen (E) status on calcium metabolism during lactation, we studied 10 long-term lactating women at 12 weeks postpartum when they were hypoestrogenic and again at 37.4 +/- 3.4 (+/- SD) weeks during the midfollicular phase of their second ovulatory cycle. Urinary and serum markers of calcium metabolism were measured at these intervals. The results revealed that when E was low, osteocalcin and hydroxyproline were increased with a lower circulating parathyroid hormone (PTH) level, whereas reciprocal changes were noted when E was increased. The findings suggest that E status can modulate PTH's ability to mobilize one's stores of calcium.