Osteoporosis in men

Abstract

Osteoporosis and fragility fractures are more prevalent in men than previously assumed and mortality rates following a major osteoporotic fracture are higher in men as compared with women. There is still uncertainty on how to interpret bone mineral density BMD in men, and few prospective studies exist that have examined the association between BMD and fracture risk. Prospective studies that have evaluated fracture risk suggest that risk increases as BMD decreases in men in a similar way as described in women. Although data are limited, prior fragility fractures also increase subsequent fracture risks in both men and women. Prevention of osteoporosis in men is important and should begin during childhood. During adulthood, calcium and vitamin D and adequate physical activity play major preventative roles. There is minimal data to suggest treatment of osteoporosis in men on the sole basis of t-score BMD measurement. However, if therapy is necessary, bisphosphonate use should be the first choice for treatment in men.