A study on the relation between sex steroids and divalent cations in women of menopausal and reproductive age group

Seena Sukumaran


Background: Menopause is the time when permanent cessation of menstruation occurs following the loss of ovarian activity. Though there is a relation between the divalent cations and sex hormones, and the lack of sufficient literature on their relation with sex hormones, the present study was conducted to compare and correlate the relation between levels of sex hormones and divalent cations in normal healthy menopausal women and the different phases of menstrual cycle in healthy women of reproductive age group.

Methods: The study was performed after institutional ethical clearance and informed consent from all the subjects. The study included three groups of 30 subjects each of reproductive age and postmenopausal women with less than 10 years of menopause and more than 10 years of menopause. Blood samples were obtained from the control group, one each in early follicular phase, ovulatory phase and during luteal phase for estimation of calcium, magnesium and the level of sex hormones and compared with that of postmenopausal group using commercially available kit. The values are expressed as mean ± S.D. The comparison between the different phases of menstrual cycle in reproductive age group with menopausal women was performed using student t test. Correlation between different parameters were done using Pearson correlation test. P value less than 0.05 was considered significant.

Results: The correlation of progesterone with magnesium and calcium/magnesium ratio in women of reproductive age group was significant. The correlation of estrogen with calcium and magnesium in women more than 10 years after menopause was found to be significant.

Conclusions: A low level of estrogen supplementation may be more acceptable, because of its negative correlation with serum magnesium, and thus helping to maintain an adequate protective level of Mg2+ circulating in the blood. Therefore, it is necessary for maintaining optimum Ca2+/Mg2+ ratio, to increase the efficacy of HRT and decrease the complications of high calcium intake in women after menopause.



Serum Ca2+, Serum Mg2+, Calcium-magnesium ratio, Estrogen, Progesterone, Menopausal women

Full Text:



Patricia M, Dolev E, Bernier LL. Magnesium and zinc status during menstrual cycle. Am J Obstet Gynaecol. 1987;157:964-8.

Ardlie NG, Nishiwaza EE, Guccione M. Effect of Ca++ and Mg++ on platelet function. Fed. Proc. 1970;29:423.

Muneyyirci-Delale O, Nacharaju VL, Dalloul M, Altura BM, Altura BT. Serum ionized magnesium and calcium in women after menopause: inverse relation of estrogen with ionized magnesium. Fertil Steril. 1999;71:869-72.

Pandya K, Lindsay R, Hart DM, Forrest C. Effect of a natural and artificial menopause on serum, urinary and erythrocyte magnesium. Clin Sci. 1980;58:255-7.

Das K, Chowdhary AR. Metallic ions during menstrual cycle in normally menstruating women. Indian J med Sci. 1997;1:52-4.

Seelig MS. The requirement of magnesium by the normal adult. Am J Clin Nutr. 1964;14:342-90.

Lindsay R, Hart DM, Forrest C. Effect of a natural and artificial menopause on serum, urinary and erythrocyte magnesium. Clin Sci. 1980;58:255-7.

McNair P, Christiansen C, Transbol IB. Effect of menopause and estrogen substitutional therapy on magnesium metabolism. Miner Electrolyte Metab. 1984;10:84-7.

Pitkin A, Maki P, Zonderman A, Resnick S. Enhanced verbal memory in nondemented elderly women receiving hormone-replacement therapy. Am J Psychiatry. 2000;158:227-33.

Gray TK, Mc Adoo T, Hatley L, Lester GE. Fluctuation of serum concentration of 125-DHCC during the menstrual cycle:Am J Obstet Gynecol. 1982;144:880-4.

Tjellesen L, Christiansen C, Hummer L, Larsen NE. Unchanged biochemical indices of bone turn over despite fluctuations in 1-25-DHCC during the menstrual cycle. Acta Endocrinologica. 1983;102:476.

Buchanan JR, Santen R, Cavaliere A, Cauffman S, Greer RB, Demers LM. Interaction between parathyroid hormone and endogenous estrogen in normal women. Metabolism. 1986;35:489-94.

Chiu KM, Arnaud CD, Ju J, Mayes D, Bacchetti P, Weitz S. Correlation of estradiol, parathyroid hormone, interleukin 6, and soluble interleukin receptor during the menstrual cycle. Bone. 2000;26:79-85.

Kenny AD. Vitamin D metabolism: physiological regulation in egg laying Japanese quail. Am J Physiol. 1976;230:1609-11.

Tanaka Y, Castillo L, Deluca HF. Control of renal vitamin D hydroxylases in birds by sex hormones. Proc Natl Acad Sci. 1976;73:2701-5.

Brommage R, Binacua C, Carry AL. Ovulation associated increase in intestinal calcium absorption during the rat estrous cycle is blunted by ovariectomy. Biol Reprod. 1993;49:544-8.

Sokoll LJ, Dawson-Hughes B. Effect of menopause and aging on serum total and ionized calcium and protein concentrations. Calcif Tissue Int. 1989;44(3):181-5.

Mauskop A, Altura BT, Cracco RQ. Intravenous magnesium sulphate rapidly alleviates headaches of various types. Headache. 1996;36:154-60.

Altura BM: Magnesium and regulation of contractility of vascular smooth muscle. Adv Microcirc. 1982;11:77-113.

Altura BT, Altura BM. Interactions of Mg and K on cerebral vessels aspects in view of stroke. Review of present status and new findings. Magnesium. 1984;3:195-211.

Dale E, Simpson G. Serum magnesium levels of women taking an oral or long term injectable progestational contraceptive. Obstet Gynecol. 1972;39:115-9.

Bruckert E, Turpin G. Estrogens and progestins in postmenopausal women; influence on lipid parameters and cardiovascular risk. Horm Res. 1955;43:100-3.

Aikawa JK. Magnesium: It’s biological significance. Boca Raton (IL): CRC press, 1981.

Zec RF, Trivedi MA. Effects of hormone replacement therapy on cognitive aging and dementia risk in postmenopausal women: a review of ongoing large-scale, long-term clinical trials. Climacteric. 2002;5:122-34.