Do men get osteoporosis too?
Men certainly get osteoporosis, and after a first fracture they are at even greater risk of a subsequent fracture or death than women. If you are a man with risk factors (testosterone deficiency, long-term corticosteroid use, or excessive alcohol use), have your bone density checked, because only 1 in 10 affected men currently receives adequate treatment.
Worldwide, approximately 40% of all osteoporosis-related fractures occur in men, and that share is still growing. Yet the widespread misconception persists that osteoporosis is a women's disease. That misconception has real consequences: only 1 in 10 men with osteoporosis receives adequate treatment.
Once a man has suffered a first fracture, his outlook is actually worse than a woman's. Both the risk of a subsequent fracture and the risk of death following that first fracture are greater in men. This makes early recognition and treatment in men not less urgent, but more urgent, than in women.
In men, up to half of all osteoporosis cases have an identifiable underlying cause. The three most common are a testosterone deficiency (hypogonadism), excessive alcohol use, and long-term use of corticosteroids, the anti-inflammatory drugs prescribed for conditions such as asthma, rheumatism, or bowel disease. Anyone with one of these risk factors is well advised to have their bone health checked, even if they have not yet had a fracture.
There is no international consensus on routine screening in men without symptoms. The Bone Health and Osteoporosis Foundation recommends a bone density scan from age 70, or earlier in the presence of risk factors. The U.S. Preventive Services Task Force, however, found insufficient evidence to recommend screening in all men. Those who do have risk factors, such as the ones mentioned above, are eligible for targeted screening.
Bisphosphonates are also used as treatment in men. These medications reduce the risk of vertebral fractures. The evidence supporting this is positive, but less extensive than in women: clinical trials in men enrolled fewer participants and ran for shorter periods. In men with a confirmed testosterone deficiency, testosterone replacement can improve bone density, but only when a clear medical indication for it exists.
All claims are based on one primary source (PMID 36382763), supplemented by two studies on screening (PMID 36920813, 32773051) and two on bisphosphonates (PMID 28492856, 12424871). The research is predominantly observational and guideline-based; for treatment in men, RCT data are more limited than in women.
How do I know if I am at risk of osteoporosis?
You can get a good sense of your risk based on age, sex, hormonal history, medication use and lifestyle. If you have multiple risk factors, ask your general practitioner for a bone density measurement.
Does physiotherapy really help if you already have osteoporosis?
Supervised exercise genuinely helps if you have osteoporosis: it slows bone loss, improves your balance and muscle strength, and reduces fear of falling. Consult a physiotherapist for a safe and effective personalised programme.
Does strength training work as well as medication for osteoporosis?
Strength training demonstrably improves bone density and offers additional benefits that medication does not provide, but the two are not alternatives to each other: when fracture risk is seriously elevated, medication has stronger evidence behind it and cannot be replaced by exercise.
What do thyroid problems have to do with osteoporosis?
Both an overactive and an underactive thyroid increase the risk of osteoporosis. If you have a thyroid condition, it is wise to discuss with your doctor whether your bones deserve extra attention.
Do people with darker skin have a higher risk of osteoporosis?
People with darker skin actually have, on average, stronger bones and a lower risk of osteoporosis than people with lighter skin, even though their vitamin D levels are more often low. If you do have concerns about vitamin D or bone health, discuss them with your doctor, as individual factors such as genetics also play a role.
How do you prevent bone loss when losing weight at an older age?
Strength training while losing weight is the best protection against bone loss, but cannot prevent it entirely. Combine it with adequate protein intake and discuss it with your doctor if you are losing weight quickly or in large amounts.