Calciotropic hormones during reproduction

This review summarizes the reported effects of the menstrual cycle, pregnancy and lactation on serum concentration of the calciotropic hormones PTH and 1,25(OH)₂D. A midcycle rise in PTH and 1,25(OH)₂D has been observed, but in the majority of studies there was no change in PTH and 1,25(OH)₂D concentrations throughout the menstrual cycle. Both total and free 1,25(OH)₂D levels are increased during pregnancy. The renal 1,25(OH)₂D production is stimulated, and there is some evidence of 1,25(OH)₂D production by decidua/placenta and fetal kidney in vitro; the decidual/placental production should not be overestimated in vivo. The increased renal 1-hydroxylase activity is possibly mediated by estrogens and PTH, although the effect of pregnancy on PTH remains uncertain. Increased serum 1,25(OH)₂D concentrations probably result in a rise of intestinal calcium absorption during pregnancy. There is a postdelivery drop in PTH and 1,25(OH)₂D levels, but they are increased when lactation is prolonged, or in mothers nursing twins. The 1-hydroxylase activity during lactation may be stimulated by PTH, but also by prolactin.