[Medical Q&A] Will excessive use of hormones lead to femoral head necrosis?

Planner: Chinese Medical Association

Reviewer: Wang Jian, Chief Physician, Nanfang Hospital, Southern Medical University

Hormones do not necessarily cause femoral head necrosis.

Short-term excessive doses or long-term high-dose use of hormones does have the risk of causing femoral head necrosis. It has been reported that when patients take a total dose equivalent to more than 200 mg of prednisone, the incidence of femoral head necrosis increases significantly. At the same time, it can be seen clinically that many patients with rheumatoid arthritis do not suffer from femoral head necrosis even if they use hormones for a long time and in large quantities; some patients use hormones for a long time, but the dosage is relatively small, and it will not cause femoral head necrosis; some patients use a relatively large dose of hormones, and femoral head necrosis occurs in a short period of time; some patients use a relatively small dose of hormones, but also suffer from femoral head necrosis.

Possible reasons for hormone-induced femoral head necrosis: Long-term accumulation of hormones in the body will increase blood viscosity, cause fat to deposit in the liver, and cause hyperlipidemia and fat embolism at the end of blood vessels. Embolism will block bone micro-vessels, and then cause ischemic necrosis of the bone. In addition, hormones can cause osteoporosis, making bones prone to collapse, which makes the femoral head "worse".