Osteoporosis affects about 1 in 20 men over age 50. Osteoporosis in men is more likely to be caused by something other than aging, such as certain medications.

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Osteoporosis affects about 2 million men over age 50 in the United States. An additional 16 million men have low bone mass (osteopenia), which can lead to osteoporosis.

Osteoporosis increases your risk of bone fracture. Although both men and women get fractures, they tend to happen later in life in men. As a result, men have about twice the mortality rate from osteoporosis fractures as women do.

Men at risk of osteoporosis can make lifestyle changes to support bone health. They can also talk with their doctors about treating underlying medical conditions that may lead to bone loss.

Men do get osteoporosis. According to the Centers for Disease Control and Prevention (CDC), osteoporosis affects about 1 in 20 men over the age of 50.

Although the condition is more common in women — 1 in 5 women over the age of 50 have osteoporosis — up to 40% of all osteoporosis-related fractures happen in men. Because men tend to experience their first fracture at an older age, these fracture are more debilitating.

Osteoporosis happens when you lose too much bone mass.

Your bones are in a constant state of renewal — old bone cells are reabsorbed into your body and new bone cells are created to replace them. As you age, your body breaks down old bone faster than it can create new bone, which means your bones become lighter, weaker, and more brittle than they used to be.

Women begin to lose bone mass at a younger age than men. For most women, rapid bone loss happens at the time of menopause. For most men, the rate of bone loss begins more slowly. But risk increases with age.

By the time they’re 65 to 70, people lose bone at the same rate, regardless of sex.

Reproductive hormones play an important role in the maintenance of healthy bone in people of all sexes. Changes in those hormone levels, such as lower testosterone levels in men and lower estrogen levels in women, can contribute to osteoporosis.

Language matters

This article uses the gendered terms “men” and “women” a lot. Generally, we prefer to distinguish between gender identity and sex assigned at birth, but specificity is key when reporting on research participants and clinical findings.

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Osteoporosis can be primary or secondary. Primary osteoporosis happens when you lose bone mass because of hormonal changes and aging. Secondary osteoporosis is caused by other underlying medical conditions, medications, and lifestyle factors that affect bone mass.

Most men with osteoporosis have secondary osteoporosis. They may have one or more underlying cause.

There are a number of factors that can increase the risk of osteoporosis in men, such as:

Conditions that affect certain organs

Some conditions, such as those affecting the stomach and intestines, can reduce your body’s ability to absorb the vitamins and minerals vital to bone health. This can be caused by things such as weight loss surgery and Crohn’s disease.

Glucocorticoid steroid medications

Glucocorticoids, which are a type of corticosteroid, are steroid medications used to treat a variety of conditions. They’re often prescribed for autoimmune conditions, cancer, and inflammatory conditions such as asthma. Ongoing use of glucocorticoid medications can cause a quick and steady decline in bone mass.

Low testosterone levels

A drop in testosterone levels increases the risk of osteoporosis in men. This drop can be from different causes, including as a side effect of glucocorticoids or other medications.

Since hormones play an important role in maintaining bone health, conditions such as hypogonadism that cause hormone levels to change can also cause osteoporosis.

Lifestyle factors

Heavy alcohol use is linked to low bone mass. Smoking is also linked to a more rapid decline in bone mass. Inactivity can also lead to osteoporosis. Weight bearing exercises such as walking and jogging are essential for keeping bones healthy.

You can take steps to prevent osteoporosis by making lifestyle changes and talking with a doctor.

Talk with your doctor about your medication

If you’re on any medication, such as glucocorticoids, ask your doctor about the risk of osteoporosis. The benefit of the medication may outweigh the risk of osteoporosis, or you may be able to work with your doctor to find an alternative treatment.

Reduce your risk of falls

Preventing falls can help reduce the risk of fractures from osteoporosis. You can start a fall prevention plan by:

  • exercising to improve strength and balance, with practices like tai chi
  • removing trip hazards from your home and installing grab bars
  • regularly checking your vision and foot health
  • speaking with a doctor about medications that make you feel weak or dizzy

Consider lifestyle changes

Weight bearing exercises are important for bone health. Consider resistance exercises like weightlifting, or sports like tennis.

Work with a doctor on a plan to quit smoking if you smoke. If you consume alcohol, consider reducing how much you drink.

Review your nutrient intake

Your body needs certain nutrients to maintain healthy bones. You can get these nutrients through your diet or through supplements. In particular, try to get the recommended daily intake of calcium and vitamin D for your age along with plenty of lean proteins.

Osteoporosis is often called the “silent disease” because it usually doesn’t cause symptoms until someone has a fracture. Symptoms of osteoporosis in the spine can be more noticeable. These may include:

  • back pain
  • getting shorter
  • changes in posture

Men at risk of osteoporosis should talk with a doctor. Screening for bone loss isn’t as common for men as it is for women. But early diagnosis leads to better treatment.

Diagnosis may involve:

  • bone mineral density test, such as a central DXA test
  • X-ray imaging
  • blood and urine tests
  • review of medical history

Treating osteoporosis typically involves one or all of the following:

  • starting medications to support bone health
  • stopping medications that may lead to low bone mass
  • treating underlying conditions
  • exercising
  • adding more calcium, vitamin D, and lean proteins to your diet
  • taking nutritional supplements

If you have experienced a vertebral compression fracture, your doctor may recommend:

  • nonsurgical treatment such as rest and a brace to restrict vertebral movement
  • surgical treatment such as kyphoplasty or vertebroplasty to correct the fracture

Here are answers to some common questions about men and osteoporosis.

Why do people think only women get osteoporosis?

People may think only women get osteoporosis because the condition is more common in women than it is in men. Several factors put women at greater risk of osteoporosis, including thinner bones, loss of bone mass after menopause, and longer life span. Nonetheless, men do get osteoporosis.

Should men take calcium supplements?

Men should make sure they get enough calcium and vitamin D. You can get this through diet or calcium supplements. The recommended daily intake for men ages 51 to 70 years is 1,000 milligrams (mg) of calcium. For men over 70, it’s 1,200 mg. Men who have trouble getting enough calcium from their diet should talk with a doctor about calcium supplements.

Can osteoporosis cause back pain?

Osteoporosis itself might not cause back pain. But, fractures that result from osteoporosis, such as vertebral compression fractures, can cause back pain ranging from mild to severe.

  • About 1 in 20 men over the age of 50 have osteoporosis.
  • Osteoporosis in men often has a secondary cause such as medications or medical conditions.
  • Exercise, adequate nutrition intake, and lifestyle changes can help prevent osteoporosis.