How Common Is Osteoporosis in Men?

Osteoporosis is commonly an age-related disease that affects even men. Although it’s relatively more prevalent in women, older men are also vulnerable. Factors such as low testosterone, poor lifestyle choices, underlying diseases, and medications impact your susceptibility. Find out how osteoporosis develops in men, what its diagnostic procedure is, and other key information about its occurrence.  

What Is Osteoporosis?

Osteoporosis is a condition that causes porosity and bone density loss. As a result, the affected individual becomes prone to fracture and bone damage. While popularly associated with women, men are also susceptible to osteoporosis. 

Unlike other age-related disorders, osteoporosis does not pose any symptoms at its onset, earning the nickname “silent disease⁽¹⁾.” As the condition gradually worsens, osteoporosis weakens the spine, giving you a hunched posture and height loss. It also comes with back pain and bone fragility. 

Causes of Male Osteoporosis

As with older women, older men experience a shift in the bone loss and replacement ratio that comes with age. After the peak bone mass years, bone loss starts to exceed the rate of bone growth. This critical change can be exacerbated by the following factors:

• Low testosterone: Testosterone is the primary male reproductive hormone, stimulating the progenitor cells from which bone formation starts. Therefore, low testosterone⁽²⁾ can drive bone loss via osteoporosis.  
• Gastrointestinal disorders: Gut problems like celiac disease, irritable bowel syndrome, and colitis can impact nutrient absorption. These include vitamin D and calcium, which are crucial in bone health. 
• Certain medications: Some drugs can weaken bones as part of their side effects, particularly if used excessively. Medications like glucocorticoids, anticonvulsants, and prostate cancer treatments can have such an impact.  
• Sedentary lifestyle: Lack of exercise⁽³⁾ increases osteoporosis in older men. Inactivity reduces the new bone tissue formation rate as the bone-building cells become static. 
• Poor diet: Nutrition can decrease bone formation, specifically if calcium, vitamin D, and other nutrients are lacking. Likewise, you also increase your risk of developing osteoporosis if you overconsume alcohol⁽⁴⁾, foods high in sodium and phosphorus, and other foods that deteriorate bone health. 

Also Read: Osteoporosis: Are You at Risk?

Prevalence of Osteoporosis in Men

It’s no secret that osteoporosis is prevalent among older women. In the US alone, 10 million Americans⁽⁵⁾ over or at the age of 50 have the bone condition. Eight million of them are women, and two million are men. By comparison, the figures may be smaller, but they hold a significant fraction of the male population.   

Osteoporosis is also more common in older men. In fact, 16 million men⁽⁶⁾ are known to have low bone mass, raising their risk of developing osteoporosis. 

Here are more facts about the prevalence of osteoporosis in older men:

• Approximately 20% of men⁽⁷⁾ aged 50 and above have osteoporosis of the hip, wrist, and spine. 
• 25% of osteoporosis-related fractures⁽⁸⁾ occur in male patients. 
• Men have a higher mortality rate (37.1%)⁽⁹⁾ from hip fractures than women (26.4%). 
• Bone loss accelerates at the age of 50⁽¹⁰⁾ and becomes even more rapid at 70⁽¹¹⁾. 

Osteoporosis Screening in Men

Diagnosing osteoporosis in men is similar to that in women. Your medical history will be reviewed, including previous fractures and bone injuries, genetic inclination to bone mass loss, the types of medications you have taken, underlying medical conditions, and lifestyle factors. 

Take the osteoporosis screening profile blood test to know your risk. Your doctor can also get a glimpse of your overall bone health through the screening. 

Frequently Asked Questions

Why is osteoporosis more common in women than in men?

Women are known to develop osteoporosis more than men for various reasons. First, women produce more estrogen, which plays a crucial role in maintaining healthy bone density. As women age, estrogen levels drop, impacting bone health. Men produce estrogen in smaller amounts, but their bone density is supported primarily by testosterone. In addition, women generally have less bone mass than men. Hence, they are more prone to osteoporosis. 

What is the best treatment for osteoporosis in men?

Treatment for osteoporosis is the same for men and women. The specific medication may vary based on your doctor’s assessment. Biphosphates and denosumab may be used, with the former being the common first choice. 

How long can a man live with osteoporosis?

While osteoporosis alone does not dictate life expectancy, research statistics have shown that men with osteoporosis who started treatment at the age of 50 can live for up to 18.2 years on average. Men who began treatment at 75 have an additional 7.2 years on average. Of course, the actual longevity of a man with osteoporosis depends on factors like the severity of the condition, age at diagnosis, lifestyle choices, and related complications. 

The Bottom Line

As osteoporosis is typically associated with women, it’s easy to overlook that it could also affect men. If you have a family history of osteoporosis, take the necessary precautions to protect your bone health. Likewise, if you go past 50, work closely with your doctor to monitor age-related health issues, including loss of bone mass. Make an action plan for aging gracefully and include bone-healthy activities in the mix. 

Sources

¹ Rinonapoli G, Ruggiero C, Meccariello L, Bisaccia M, Ceccarini P, Caraffa A. Osteoporosis in Men: A Review of an Underestimated Bone Condition. Int J Mol Sci. 2021 Feb 20;22(4):2105. doi: 10.3390/ijms22042105. PMID: 33672656; PMCID: PMC7924179.

² Gaffney CD, Pagano MJ, Kuker AP, Stember DS, Stahl PJ. Osteoporosis and Low Bone Mineral Density in Men with Testosterone Deficiency Syndrome. Sex Med Rev. 2015 Oct;3(4):298-315. doi: 10.1002/smrj.63. Epub 2015 Nov 10. PMID: 27784602.

³ Pinheiro MB, Oliveira J, Bauman A, Fairhall N, Kwok W, Sherrington C. Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behavior. Int J Behav Nutr Phys Act. 2020 Nov 26;17(1):150. doi: 10.1186/s12966-020-01040-4. PMID: 33239014; PMCID: PMC7690138.

⁴ Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, Baigi V, Mansournia N, Etminan M, Mansournia MA. The effect of alcohol on osteoporosis: A systematic review and meta-analysis. Drug Alcohol Depend. 2019 Apr 1;197:197-202. doi: 10.1016/j.drugalcdep.2019.01.025. Epub 2019 Feb 27. PMID: 30844616.

⁵ U.S. Department of Health and Human Services (n.d.). Osteoporosis Workgroup. Healthy People 2030. Retrieved April 23, 2024, from https://health.gov/healthypeople/about/workgroups/osteoporosis-workgroup#about

⁶ Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014 Nov;29(11):2520-6. doi: 10.1002/jbmr.2269. PMID: 24771492; PMCID: PMC4757905.

⁷ Melton LJ 3rd. The prevalence of osteoporosis: gender and racial comparison. Calcif Tissue Int. 2001 Oct;69(4):179-81. doi: 10.1007/s00223-001-1043-9. PMID: 11730244.

⁸ Björnsdottir, S., Clarke, B. L., Mannstadt, M., & Langdahl, B. L. (2022). Male osteoporosis-what are the causes, diagnostic challenges, and management. Best Practice & Research Clinical Rheumatology, 36(3), 101766. https://doi.org/10.1016/j.berh.2022.101766

⁹ Kannegaard, P. N., Eiken, P., & Abrahamsen, B. (2010). Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age and Ageing, 39(2), 203-209. https://doi.org/10.1093/ageing/afp221

¹⁰ Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment. J Biomed (Syd). 2018;3:40-49. doi: 10.7150/jbm.23390. PMID: 30505650; PMCID: PMC6261527.

¹¹ Kanis JA, Adami S. Bone loss in the elderly. Osteoporos Int. 1994;4 Suppl 1:59-65. doi: 10.1007/BF01623438. PMID: 8081062.