Osteoporosis in Men

Osteoporosis is a disease that causes the skeleton to weaken and the bones to break. It poses a significant threat to millions of men in the United States.

Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs. It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss. However, in the past few years the problem of osteoporosis in men has been recognized as an important public health issue, particularly in light of estimates that the number of men above the age of 70 will continue to increase as life expectancy continues to rise.

How Is Osteoporosis Diagnosed in Men?

Osteoporosis can be effectively treated if it is detected before significant bone loss has occurred. A medical workup to diagnose osteoporosis will include a complete medical history, x rays, and urine and blood tests. The doctor may also order a bone mineral density test. This test can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized BMD test is called a dual-energy x-ray absorptiometry, or DXA test. It is painless a bit like having an x ray, but with much less exposure to radiation. It can measure bone density at your hip and spine.

It is increasingly common for women to be diagnosed with osteoporosis or low bone mass using a BMD test, often at midlife when doctors begin to watch for signs of bone loss. In men, however, the diagnosis is often not made until a fracture occurs or a man complains of back pain and sees his doctor. This makes it especially important for men to inform their doctors about risk factors for developing osteoporosis, loss of height or change in posture, a fracture, or sudden back pain.

Some doctors may be unsure how to interpret the results of a BMD test in men, because it is not known whether the World Health Organization guidelines used to diagnose osteoporosis or low bone mass in women are also appropriate for men. Although controversial, the International Society for Clinical Densitometry recommends using separate guidelines when interpreting BMD test results in men.

What Treatments Are Available?

Once a man has been diagnosed with osteoporosis, his doctor may prescribe one of the medications approved by the FDA for this disease. The treatment plan will also likely include the nutrition, exercise, and lifestyle guidelines for preventing bone loss listed at the end of this fact sheet.

If bone loss is due to glucocorticoid use, the doctor may prescribe a medication approved to prevent or treat glucocorticoid-induced osteoporosis, monitor bone density and testosterone levels, and suggest using the minimum effective dose of glucocorticoid.

Other possible prevention or treatment approaches include calcium and/or vitamin D supplements and regular physical activity.

If osteoporosis is the result of another condition (such as testosterone deficiency) or exposure to certain other medications, the doctor may prescribe several anabolic steroids. Anabolic steroids are largely used in treatment of testosterone deficiency and are used as a part of testosterone replacement therapy. Thus anabolic steroids had a positive exposure in osteoporosis treatment.