Men and osteoporosis

Why it is missed

Osteoporosis is often framed as a women’s health issue, so men may not get screened or may not recognize a fracture as a bone-health warning sign. That delay matters.

In men, secondary contributors are common enough to look for deliberately: medications, low testosterone, alcohol use, smoking, malabsorption, inflammatory disease, kidney disease, cancer treatments, low body weight, or other medical conditions.

When to ask about bone health

• A fracture after age 50, especially from a simple fall.
• Height loss or concern for spine compression fractures.
• Long-term steroid use.
• Low testosterone or symptoms that raise the question.
• Heavy alcohol use, smoking, or unexplained weight loss.
• Family history of hip fracture or osteoporosis.

A plain way to start the conversation

You do not need to know the answer before the visit. A good first question is simply: “Given my fracture or risk factors, should we evaluate my bone health?”

References

1. Morin SN, Leslie WD, Schousboe JT. Osteoporosis: a review. JAMA. 2025. doi:10.1001/jama.2025.6003.
2. Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019;393(10169):364-376. doi:10.1016/S0140-6736(18)32112-3.
3. Ebeling PR, Nguyen HH, Aleksova J, Vincent AJ, Wong P, Milat F. Secondary osteoporosis. Endocr Rev. 2022;43(2):240-313. doi:10.1210/endrev/bnab028.