Low Testosterone and Bone Health
Bone Growth and Decreased Bone Density
When you’re young, bones grow in length and density. As a teen, you reach maximum height, yet bones continue to grow denser until age 30. At that point, bones slowly start to lose density or strength. The density of your bones is affected by heredity, diet, sex hormones, physical activity, lifestyle choices and the use of certain medications.
Most people don't know they have decreased bone density until they get tested or they break a bone. A bone mineral density (BMD) test is the best way to check bone health, since osteoporosis is basically a silent disease. Osteoporosis causes the skeleton to weaken and the bones to break. It poses a significant threat to more than two million men in the United States. One in four men over age 50 will have an osteoporosis-related fracture in their remaining lifetime.
But men don’t get osteoporosis as often as women. That’s because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal changes.
Male Osteoporosis and Testosterone Effects on Bone
Hypogonadism is widely considered to be an important cause of male osteoporosis, occurring in up to 20% of men with vertebral fractures and 50% with hip fractures. It’s of note that as testosterone plays an important part in maintaining a man’s skeleton, it also improves bone density in men with hypogonadal osteoporosis. Testosterone is known to decrease bone resorption and stimulate bone mineralization.
Treatments with calcium plus vitamin D and bisphophonates are widely used in men, when osteoporosis is documented and hypogonadism has been excluded. Because there is a lack of information about male osteoporosis, there is not a lot of communication about how to handle the disease, which is a debilitating side effect of testosterone deficiency. It is practical for all men beginning testosterone replacement to receive calcium and vitamin D, and maintain a reasonable exercise regimen. Baseline BMD and follow-up bone density measurements are appropriate with consideration of bisphosphonate treatment as a possibility for those men developing osteoporosis.
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