Osteoporosis occurs when your body cannot replace bone as quickly as it breaks down old bone (a natural process called “bone turnover”).

What causes osteoporosis in men?

Osteoporosis occurs when your body cannot replace bone as quickly as it breaks down old bone (a natural process called “bone turnover”). Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Certain factors raise a man’s risk of developing osteoporosis.

Osteoporosis risk factors

Personal and family history

  • White race
  • Age 70 and older
  • Thinness
  • Prior fracture as an adult, mainly after age 50
  • History of delayed puberty
  • Family history of osteoporosis or a parent who had a fracture

Lifestyle

  • Cigarette smoking
  • Excess alcohol use
  • Low calcium and vitamin D intake
  • Lack of physical activity

Health problems and medicines

  • Low testosterone (hypogonadism), including low testosterone caused by treatment for prostate cancer
  • High calcium levels in the blood (hypercalcemia) or urine (hypercalciuria)
  • Vitamin D deficiency
  • Disorders that affect many parts of the body including hyperthyroidism (overactive thyroid), hyperprolactinemia, kidney failure, liver failure, celiac disease, and certain cancers
  • Use of steroid medications such as prednisone and cortisone for more than three months – called glucocorticoid-induced osteoporosis

How is osteoporosis in men diagnosed?

The most common way to detect osteoporosis is with a bone density test such as a dual-energy x-ray absorptiometry (DXA or DEXA) scan. This test measures bone mineral density (BMD) at the lower spine and hip, and gives a score called a T-score.

A T-score of -2.5 or lower indicates osteoporosis, and a T-score between -1.0 and -2.5 shows osteopenia. A score above -1.0 is normal.

DXA can also show vertebral fractures (breaks in the bones that make up your spine). People who have had a vertebral fracture are more likely to have more fractures, so vertebral fracture assessment can have important clinical implications.

Fast facts

  • Osteoporosis affects nearly half of men and women over the age of 75
  • After age 50, six percent of all men will suffer a hip fracture as a result of osteoporosis
  • The most common cause of male osteoporosis is testosterone deficiency
  • Fractures commonly occur in the hip, spine, and wrist
  • Breaks in the hip and spine are of special concern because they almost always require hospitalisation and major surgery, and may lead to other serious
  • Consequences, including permanent disability and even death
  • In severe cases of osteoporosis a sneeze or sudden movement may be enough to break a bone
  • Men have a higher mortality rate due to hip, vertebral, and other major fractures.
  • The word osteoporosis literally means “porous bones”