Men Also Suffer From Osteoporosis

TV ads target women for their risk of osteoporosis and resulting bone fractures of the hip and vertebrae (spine). While the fracture risk is greater in women than in men, one third of hip fractures in older individuals occur in men. The incidence of fracture increases with age in both men and women. On average, men suffer hip and spine fractures at a 10 year older age than women, but men fare worse than women after a fracture.

Estrogen in women and both testosterone and estrogen (formed from testosterone in men) are required for the maintenance of healthy bones. The danger of osteoporosis is greater and earlier in women because estrogen production stops rather abruptly at the onset of menopause whereas testosterone levels fall more slowly in men.

Risk factors

Other risk factors for osteoporosis in men in addition to older age include the following:

  • Prior or present treatment with corticosteroids, such as prednisone for rheumatoid arthritis or other disorders
  • Low testosterone levels
  • Excessive thyroid hormone replacement for an underactive thyroid gland
  • Excessive alcohol intake
  • Low vitamin D levels
  • Inadequate intake of calcium
  • Cigarette smoking
  • Family history of hip fractures
  • A parathyroid secreting tumor in the parathyroid gland

Diagnostic tests

Just like in women, the best tests for osteoporosis in men usually are DEXA scans of the hip and spine to assess bone mineral density. However, spine scans are often helpful and a forearm DEXA is a good predictor of fracture risk. DEXA scans are recommended for men at age 70, or earlier in those with significant risk factors. Blood tests may include measurements of testosterone and vitamin D levels.  


Men may benefit from taking supplements of vitamin D and calcium. Although testosterone levels fall as men age, in most men, blood testosterone levels are adequate to maintain bone health. However, testosterone may fall dramatically with cancer chemotherapy, especially with some forms of treatment for prostate cancer. Studies do show some improvements in bone mineral density when testosterone replacements are prescribed for men with extremely low testosterone levels. Other FDA-approved treatments for men with osteoporosis include Alendronate, Risedronate, Zeledronic acid and Teriparatide.     


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