Can Men Get Osteoporosis? Risk Factors and Screening

Yes, men absolutely can and do get osteoporosis. Being diagnosed or told you are at risk can be unsettling, especially since osteoporosis is often mistakenly thought of as a disease that only affects postmenopausal women. This page will help you understand how osteoporosis affects men, what factors increase your risk, and what steps you and your doctor can take to evaluate and protect your bone health.

Osteoporosis is a condition that weakens bones, making them more fragile and more likely to break. It is often called a “silent disease” because you cannot feel your bones getting weaker, and it usually causes no symptoms until a fracture occurs. Common sites for these fractures include the hip, spine (vertebral fractures), and wrist. While men have larger bones and do not experience the sudden loss of estrogen that women do at menopause, they still lose bone density gradually as they age ^[1]. Male osteoporosis is a significant health issue that is often under-screened and undertreated ^[2].

Primary vs. Secondary Osteoporosis

When discussing osteoporosis, doctors generally categorize it as either primary or secondary:

• Primary osteoporosis includes gradual, age-related bone loss, as well as cases with no identifiable cause (idiopathic). As men age, their bones naturally become less dense ^[3].
• Secondary osteoporosis occurs when bone loss is caused or accelerated by another medical condition, a specific lifestyle factor, or a medication. In men, secondary causes are very common and often coexist with age-related bone loss, meaning an evaluation for secondary causes is important even if bone density does not appear severely low ^[4].

Key Risk Factors for Men

Several specific factors can increase a man’s risk of developing osteoporosis. The risk is often highest when multiple factors combine—for example, getting older while also having a chronic health condition.

Medications That Affect Bone

• Androgen Deprivation Therapy (ADT): Used to treat prostate cancer, ADT intentionally lowers testosterone levels. While important for cancer care, it increases bone loss and fracture risk ^[5][6]. Do not stop your cancer treatment on your own; instead, discuss baseline and follow-up bone risk assessments with your oncology team.
• Glucocorticoids (Steroids): Long-term use of medications like prednisone for inflammatory conditions is a well-recognized cause of secondary osteoporosis ^[3][7]. Never stop prescribed steroids suddenly; ask your prescribing doctor about individualized bone-protection measures.

Hormonal and Nutritional Factors

• Low Testosterone (Hypogonadism): Low levels of male hormones are a well-documented risk factor ^[8][3]. Diagnosis requires proper clinical evaluation, often with repeat morning blood tests. Note that while correcting testosterone may help, it is not an automatic substitute for proven fracture-prevention therapies.
• Low Vitamin D and Calcium: Vitamin D and calcium are essential for bone health. Vitamin D deficiency is an independent risk factor for osteoporosis ^[3].
• Low Body Weight and Energy: Having a very low body weight, unintentional weight loss, or consistently taking in too few calories (low energy availability) can disrupt hormone levels and weaken bones ^[9].

Other Common Risk Factors

Your doctor should review your medical history for other contributing factors ^[10][11], such as:

• Smoking and heavy alcohol use
• Physical inactivity or a history of frequent falls
• A parent who had a hip fracture
• Chronic conditions such as diabetes, chronic kidney or liver disease, chronic obstructive pulmonary disease (COPD), rheumatoid arthritis, or thyroid/parathyroid disorders
• Conditions that impair nutrient absorption (like celiac disease)

Warning Signs: When to Seek Prompt Care

Because osteoporosis is typically silent, it is critical to recognize potential warning signs of a fracture. Seek prompt medical evaluation if you experience:

• Sudden, severe back, hip, or groin pain, especially after a minor fall or injury
• An inability to bear weight
• A noticeable new loss of height or a stooped posture, which can indicate a spinal (vertebral) fracture ^[12]

A fracture from a simple standing-height fall (a “low-trauma” fracture) is a major warning sign that warrants investigation, whether it occurs in the hip, spine, wrist, shoulder, or pelvis ^[7].

Screening and Diagnosis

Because male osteoporosis is less common than female osteoporosis, guidelines for screening can be confusing. The 2025 U.S. Preventive Services Task Force (USPSTF) concluded there is currently insufficient evidence to recommend for or against routine population screening for asymptomatic, average-risk men ^[13].

However, this does not mean high-risk men should avoid evaluation. If you have experienced a fragility fracture, take glucocorticoids, receive ADT, have low testosterone, or have other major risk factors, you warrant a clinical diagnostic evaluation regardless of routine screening policies. Additionally, some major medical organizations do recommend screening for all men aged 70 and older ^[14][15].

Diagnosis and risk assessment typically involve:

1. DXA Scan: A dual-energy X-ray absorptiometry (DXA or DEXA) scan is a specialized, painless test that measures bone mineral density ^[15].
2. Absolute Fracture Risk (FRAX): Because a DXA score alone doesn’t tell the whole story (for instance, people with diabetes can have higher fracture risk despite better-looking DXA scores ^[11]), doctors often use tools like FRAX. FRAX estimates your absolute fracture risk—your percentage chance of having a major osteoporotic fracture over the next 10 years—by combining your DXA results with your clinical risk factors (like age, smoking, and prior fractures) ^[16][17].

Next Steps and Prevention

If you are diagnosed with osteoporosis or high fracture risk, there are effective steps to take:

• Review Your History: Work with your doctor to review your fracture history, current medications, and assess for secondary causes with appropriate blood tests.
• Lifestyle Measures: Individualized advice often includes ensuring adequate calcium and vitamin D intake, quitting smoking, moderating alcohol, and engaging in weight-bearing, resistance, and balance exercises to build strength and prevent falls. If you already have severe osteoporosis or a spinal fracture, get specific guidance from a physical therapist or doctor before starting high-impact exercises.
• Medication: If your fracture risk is high, several proven pharmacologic treatments exist for men that can increase bone density and significantly reduce the risk of future fractures ^[18].