Low Testosterone and Osteoporosis—It’s Not Just a Women’s Problem

Osteoporosis, the loss of bone mass and density that leads to a weakening of the skeletal structure and an increased risk of fractures, is commonly considered to be a “women-only” problem.

There are some facts that contribute to this mistaken assumption:

  • Men have larger skeletons which deteriorate more slowly
  • Male bone loss starts later in life than female bone loss
  • Men don’t experience the period of rapid hormonal fluctuation comparable to menopause in women that leads directly to rapid, observable bone loss

A middle-aged man wearing a white t-shirt sits on a bed with white sheets. He is facing away from the camera, holding his neck and back. Research has found a connection between osteoporosis and low testosterone levels.

Unfortunately, many older men only learn about male osteoporosis when a fracture suddenly occurs. In these cases, bone loss has often progressed for years without detection or treatment.

Medical science has observed a connection between male degenerative bone loss and chronic low testosterone.

Your Bone Health—Changes Over Time

During the early years of development, new bone forms at a faster rate than old bone is worn away, which results in skeletal growth.

Production peaks at around 30 years old when a steady balance between tissue generation and loss is established.

At around 50, women may begin experiencing a more rapid loss of bone tissue due to the hormonal fluctuation and eventual decline associated with menopause.

As men and women age beyond 60, they lose bone at approximately the same rate, and the absorption of calcium, an essential nutrient for bone health, decreases in both sexes.

The Causes of Osteoporosis and Low Bone Density in Men

Osteoporosis in elderly men is usually caused by age-related bone loss.

However, men experiencing excessive bone loss at earlier ages usually have at least one other health or lifestyle factor that has accelerated the decline, including:

  • Hypogonadism—the medical term for low testosterone
  • Glucocorticoid medications—steroid medications used to treat diseases such as asthma and rheumatoid arthritis
  • Alcohol abuse
  • Smoking
  • Gastrointestinal disorders that impair the absorption of nutrients critical for bone regeneration and health
  • Immobilization or inactivity that drastically reduces weight-bearing activity

Click here for more information on the diagnosis and treatment of general osteoporosis.

The Link Between Osteoporosis and Low Testosterone

Low testosterone levels and premature bone loss are often co-occurring conditions.

In other words, men diagnosed with low testosterone often have lower bone density, and men diagnosed with low bone density often are found to have clinically low testosterone levels.

One study shows that 35% of men younger than 50 years old who were attending an andrology or infertility clinic had low bone mineral density consistent with osteopenia (borderline osteoporosis) in the spine and/or hip.

Such evidence supports the conclusion that low testosterone plays a significant role in early loss of bone mass and the development of osteoporosis.

Testosterone Replacement Therapy—An Effective Treatment

Scientific studies support the restoration of normal testosterone levels through Testosterone Replacement Therapy (TRT) as an effective treatment for early bone density loss associated with clinical hypogonadism (low testosterone).

A recent study known as the Bone Trials (one part of a series of scientific research projects studying the symptoms and treatment of low testosterone) found that men who received TRT for 1 year experienced significant increases in both volumetric bone mineral density and estimated bone strength, particularly in the spine.

The study concluded that:

“(There are) significant benefits of testosterone therapy on bone mineral density and estimated bone strength in older men with aging-related low testosterone. This study adds to the evidence base, showing that testosterone has significant osteoanabolic effects, which supports the use of testosterone therapy in men with low bone mineral density.”

Low Testosterone—Learn The Causes and Symptoms

Low T is a problem that is often not reported by many patients and frequently ignored by providers, but the healthy balance of testosterone and your other hormones is critical to the proper functioning of your body’s essential systems.

If your testosterone levels decrease, you may develop symptoms that affect your quality of life and overall health, osteoporosis and bone fragility being just one important example.

Read our comprehensive guide to low testosterone symptoms and causes for answers to the most common questions about this damaging yet treatable condition.

Read the Guide


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(Bill) William J. White, PA-C

(Bill) William J. White, PA-C brings over 20 years of surgical experience to our practice. He is a decorated veteran of the United States Army where he served for nearly 6 years with duty assignments, both here and abroad.   During his military career, Bill was trained as a Certified Surgical Technologist, and following an Honorable Discharge from the Army, he attended Texas Tech University.   He graduated with a Bachelor of Science in Biology and went on to attend PA School at the University of Texas Southwestern Medical Center at Dallas. He spent the first 10 years of his career in Neurosurgery.

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