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Bone is a dynamic tissue that undergoes renewal and repair throughout life through the process of bone remodelling. Skeletal homeostasis is achieved through coupled and balanced bone resorption and bone formation. Several local and systemic factors regulate these processes, including sex hormones. Estrogenes and androgens influence growth, maturation and maintenance of bone mass. Sex homones act on bone through multiple mechansims. Sex hormones influence synthesis and secretion of many growth factors and cytokines, and play therefore a central role in the regulation of bone metabolism. The local and systemic regulation of bone metabolism occurs through fine tuned processes, which are influences by sex hormones and the aging process. This is evidenced by the fact that hypogonadims in both sexes is associated with bone loss an estrogen deficiency at the menopause is an important pathophysiological factor in the developement of postmenopausal osteoporosis. Treatment with aromatese inhibitors for breast cancer and antiandrogen treatment for prostate cancer are associated with an increased fracture risk and warrant increased diagnostic and treatment awareness.