Today more than 2 million American men have osteoporosis. Another 3 million are at risk for the disease according to the National Osteoporosis Foundation. Men have one-third of all the hip fractures each year. A third of these will not survive more than one year. Men also often have fractures of the spine and wrist due to osteoporosis. About 4-6% men older than 50 have osteoporosis and 33-47% have osteopenia.

Because men have larger, stronger bones and don’t have the abrupt hormonal changes that women do following menopause, osteoporosis is seen less often in men. Also bone loss begins later and advances more slowly in men. Fractures in men occur about 10 years later than in women. Osteoporosis in men however is becoming more of a public health issue because the number of men over 70 will double between 1993 and 2050.

By age 65 or 70, men and women lose bone mass at similar rates. Calcium absorption also decreases in both sexes.

Men should get a bone mineral density (BMD) test if they have a bone fracture, lower back pain, or notice height loss. Falling on an outstretched hand shouldn’t break the wrist. If it does there is a problem. In men there is primary and secondary osteoporosis. In primary there may be no identifiable cause (idiopathic) or it may be bone loss due to age. This may overlap with secondary osteoporosis that is due to a variety of causes such as low testosterone, steroid use for longer than 6 months (prednisone, cortisone), and alcoholism. Steroids are anti-inflammatory medicines often taken for asthma and rheumatoid arthritis. They cause bone to be removed faster than it is formed. Those taking long-term steroids should have their BMD assessed.

Factors that increase the risk of osteoporosis include: cigarette smoking, excessive alcohol intake (over 2 drinks daily), inactive lifestyle, and advanced age. Not smoking, drinking in moderation, exercising regularly, and eating a balanced diet rich in calcium can help prevent osteoporosis. Drinking excessive soft drinks (soda) and caffeine may also contribute to bone loss. See Teens and Osteoporosis for explanation.

Medications to treat osteoporosis are identified on this website and are the same for men and women except hormone replacement therapy and raloxifene, a selective estrogen receptor modulator (SERM). Some men may require testosterone replacement.

Top of Page