Do men suffer with osteoporosis?

Abstract

Osteoporotic fractures in men are a neglected public health problem. The pathogenesis of bone loss is incompletely understood but is probably due to reduced bone formation rather than increased bone resorption. Primary or secondary hypogonadism is a common and treatable cause of osteoporosis and should be excluded in all men presenting with spine or hip fractures. Alcohol excess, with or without hypogonadism, is a most important attributable risk factor for osteoporosis in men. There is no known treatment for osteoporosis in men (as there have been no clinical trials using anti fracture efficacy as an endpoint in men) and few well designed trials examining the effects of drugs on bone mineral density (BMD). Bisphosphonates, while reducing fracture rates in women, have only been shown to increase BMD in men Calcium supplementation may slow bone loss. Anabolic agents, such as nandrolone have not been adequately studied. Fluoride therapy cannot be recommended as bone strength does not appear to increase despite the well documented increase in BMD. Risk factors such as alcohol excess and tobacco use should be corrected.