22 – Osteoporosis in Men

Publisher Summary This chapter summarizes the factors associated with osteoporosis in men. Approximately 20% of the total health care costs of osteoporosis can be attributed to fractures in men. Mostly elderly men experiences osteoporotic fractures. There is a rapid increase in the incidence of vertebral and hip fractures in men beginning at about age 65 to 70 years. Common causes of secondary osteoporosis in men: glucocorticoid excess, alcohol excess, and hypogonadism. There are multiple contributing causes, including: renal stone disease, malabsorption, smoking, and anticonvulsants, and so on. The predictors of fracture risk can be identified by longitudinal studies and factors associated with increased fracture risk in men. The factors associated with lower bone mass and correlates of higher bone mass are the major determinates of bone mass. The basic treatments of osteoporosis in men includes: pharmacologic therapy, testosterone replacement therapy, and calcium and vitamin D nutrition. Testosterone replacement therapy can result in some gain in bone mass in hypogonadal men.