Osteoporosis
in men

Men, of all ages, can have osteoporosis. It's more common in older people.

1 in 5 men over the age of 50 will break a bone because of osteoporosis.

If your doctor thinks you may have osteoporosis, they can refer you for a range of scans and tests. This includes a fracture risk assessment. The scans and tests help to find out if you have osteoporosis, your risk of breaking a bone and if you need a drug treatment.

If your doctor is unfamiliar with osteoporosis in men, it may help to show them this web page.

Should men see an osteoporosis specialist?

It's important for men, and especially younger men, to see a specialist who understands osteoporosis. As osteoporosis is less common in men, there are many factors to think about when diagnosing and treating the condition. A specialist can help to:

• find out if there's an underlying reason for your osteoporosis

• recommend osteoporosis drug treatments

• interpret the results of your DEXA scan.

At least half of men with osteoporosis have an underlying reason for their osteoporosis. But we don't always know why men have osteoporosis.

Many of the causes of osteoporosis are the same in men and women. They include coeliac disease, steroids, eating disorders and age.

But some treatments and medical conditions increase the chance in men alone. This is because they cause very low levels of testosterone (male hormone) in the body. Testosterone is important for bone strength. The treatments and conditions include:

• Klinefelter's syndrome

• Kallmann syndrome

• injury to the testicles

• some conditions that affect the pituitary gland

• some prostate cancer drug treatments

• radiotherapy and chemotherapy.

Prostate cancer treatments

Prostate cancer treatments can affect bone strength as they may:

• stop your body from making testosterone

• change the way testosterone works in the body.

The treatments help reduce the chance of the cancer growing or returning. This is because prostate cancer cells usually need testosterone to grow.

It's important to talk to your doctor about having a fracture risk assessment while on treatment. This can assess your chance of breaking a bone and whether you would benefit from a drug treatment.

Your doctor may also refer you to an osteoporosis specialist.

Osteoporosis drug treatments help to strengthen bones, making them less likely to break.

Your doctor may recommend a drug treatment if your chance of breaking a bone is high enough that your bones would benefit from it.

There are different drug treatments available for men with osteoporosis. These include:

• alendronate

• risedronate

• zoledronate

• denosumab

• teriparatide

These osteoporosis drug treatments are licensed for men of all ages. This means research has shown they are safe and effective at reducing the chance of broken bones in men.

There are other osteoporosis drug treatments. But we don't have enough research to be sure they reduce the chance of broken bones in men.

Some treatments are not suitable for men. This is because they contain or act like oestrogen (a female hormone) inside the bone. These drugs are hormone replacement therapy (HRT) and raloxifene.

Testosterone replacement therapy

Testosterone replacement therapy acts like testosterone in the body. It causes your testosterone levels to increase.

Testosterone replacement therapy is mainly used to treat men with very low testosterone levels caused by a condition, like Klinefelter's syndrome and Kallmann syndrome. It may help to strengthen bones.

If your testosterone level is normal, testosterone replacement therapy is unlikely to help your bones. But there are other osteoporosis drug treatments for men.

Testosterone replacement therapy is available as an injection or gel. A specialist at a hospital will prescribe it.

Testosterone replacement therapy won't be suitable for you if you have:

• prostate, breast or liver cancer

• heart problems

• diabetes

• blood clotting disorders.

You'll need regular blood tests and blood pressure checks while you're on testosterone replacement therapy. This is to monitor your testosterone levels and make sure you're taking the right dose for you.

Testosterone replacement therapy is usually only offered to men under the age of 60. This is because it's been linked to an increased chance of prostate cancer and heart disease as you get older. The levels of risk vary from one person to another. They depend on things like your age, weight, medical history and family history.

You can keep taking testosterone replacement therapy as long as the benefits outweigh the risks. Some men stay on the treatment for many years. How long you take testosterone replacement therapy for depends on your own situation.

It's important to discuss your own benefits and risks with your doctor, so you can decide what's right for you. A regular review of your treatment choices is also useful.

We can all look after our bones by:

• eating a well-balanced, varied and calcium-rich diet

• having safe exposure to sunlight, so that your skin makes vitamin D

• staying active by doing both impact and strength exercises

• not smoking

• not drinking more than the recommended levels of alcohol

• taking steps to lower your chance of falling, as falls can lead to broken bones.

Men often tell us they worry about how osteoporosis and broken bones could affect their job. This is especially the case if their job involves heavy lifting.

It's normal to feel concerned. But you should be able to keep working and doing the activities that are important to you.

There are some adjustments you can make to reduce the chance of broken bones in the workplace. They include:

• reducing the size of loads you lift

• reducing repetitive bending, twisting and turning

• using safe moving and lifting techniques to keep your back straight.

There are also things you can do to help manage pain if you've had painful broken bones.

It's important to tell your employer if you feel unable to carry out tasks you were able to do before or need some adjustments. Your employer has a duty to make reasonable adjustments in the workplace to accommodate your needs. And this protects you from unlawful discrimination on the grounds of disability.

Find out more about employment and work life.

Is there any financial help available?

Osteoporosis itself doesn't make you eligible for disability-related financial support. But you may be able to get financial help if your broken bones make it hard for you to do everyday tasks, get around or work. You may also be able to get financial support if you're caring for someone with broken bones.

Find out about the different types of financial support that may be available for you.

In this blog, Gareth, Geoffrey and Joe tell us about their experiences of osteoporosis and the advice they would offer their younger selves if they could.

Health Information

Our health information is for everyone living with osteoporosis.

We have a series of information films which have been developed together with people who have experience of osteoporosis and broken bones, and who understand what you might be going through.

We also have lots of booklets and resources available to download and print. Our fact sheets and booklets cover topics including general bone health, drug treatments, scans and tests, risk factors and living with osteoporosis and broken bones.

Emotional wellbeing and osteoporosis

Living with osteoporosis can have an impact on your emotional health. But you're not alone and we're here to support you. Find information and support to help you manage the emotional impact of osteoporosis and broken bones.

Online community

The online community is a welcoming, safe space for you to share your experiences and connect with other men. It also has a dedicated space for men.

Men's Network

Designed by men, for men. The Men's Network is a place for men with osteoporosis to connect and support each other.

Support groups

Through our network of support groups, you can connect with people in your area going through the same things as you. Find your local support group.