Osteoporosis, often perceived as a “woman’s disease,” is significantly underdiagnosed and undertreated in men, leading to potentially more severe consequences. Even as traditionally associated with postmenopausal women, bone density loss affects men as well and the gap in awareness and treatment is a growing concern for public health officials. Recent data indicates a concerning trend: men with osteoporosis experience higher rates of comorbidity and are more likely to be taking multiple medications compared to their healthy counterparts, yet often remain undiagnosed.
The misconception that osteoporosis primarily affects women has historically overshadowed the risk faced by men. This has resulted in a lack of routine screening and a lower threshold for intervention in male patients. However, approximately one in three osteoporotic fractures occur in men, and the outcomes for men experiencing these fractures are frequently more serious. This disparity demands a shift in medical practice and public awareness to ensure equitable care for all genders.
The Underdiagnosis of Osteoporosis in Men
The reasons for this underdiagnosis are multifaceted. Men tend to have higher bone mass than women, meaning they may not experience significant bone loss until later in life. This delayed onset can lead to a false sense of security and a lack of proactive screening. Societal norms often discourage men from seeking preventative healthcare, contributing to delayed diagnosis. According to research published by the European Foundation for the Study of Osteoporosis, men often present with more severe osteoporosis at the time of diagnosis, suggesting a longer period of undetected bone loss.
Dr. Charlotte Verroken, writing in Ortho-Rheumato in January 2025, highlighted the significant underestimation of osteoporosis in men. The article emphasizes that while 1 in 3 osteoporotic fractures occur in men, the condition is largely viewed as a postmenopausal female issue. This perception contributes to the substantial underdiagnosis and undertreatment of the condition in the male population. The diagnostic process, management, and treatment of osteoporosis are, however, comparable between genders.
Secondary Osteoporosis: A Common Cause in Men
Unlike women, where osteoporosis is often linked to estrogen deficiency following menopause, osteoporosis in men is frequently “secondary,” meaning it’s caused by other underlying medical conditions or medications. These can include long-term corticosteroid use, hypogonadism (low testosterone), chronic kidney disease, hyperparathyroidism, and certain gastrointestinal disorders. Identifying and addressing these underlying causes is crucial for effective management of osteoporosis in men.
H&W (Huisarts & Wetenschap) reported in November 2025 that older men are more likely than women to experience fractures due to secondary osteoporosis. This underscores the importance of comprehensive medical evaluations to identify and address contributing factors. The publication notes that the risk of osteoporotic fractures is approximately 50% for women and 20% for men over the age of 50. This difference doesn’t diminish the risk for men, but highlights the demand for targeted screening and intervention.
Rising Prevalence and the Impact of Comorbidities
Recent studies demonstrate a concerning increase in osteoporosis prevalence among men. Data from Denmark shows a rise of over 80% in the prevalence of osteoporosis in Danish men between 1996 and 2018. This increase is coupled with a higher incidence of comorbidities – the presence of multiple medical conditions simultaneously – and increased medication use among men diagnosed with osteoporosis. This suggests that osteoporosis is not an isolated condition but often occurs in conjunction with other health challenges, potentially complicating treatment and management.
The presence of comorbidities can similarly influence the severity of osteoporosis and the risk of fractures. For example, men with chronic inflammatory conditions or gastrointestinal disorders may have impaired calcium absorption, exacerbating bone loss. Similarly, certain medications, such as proton pump inhibitors used to treat acid reflux, can interfere with calcium absorption and increase fracture risk.
Risk Factors for Osteoporosis in Men
Several factors can increase a man’s risk of developing osteoporosis. These include:
- Age: Bone density naturally declines with age.
- Family History: A family history of osteoporosis increases risk.
- Low Testosterone Levels: Hypogonadism can contribute to bone loss.
- Medications: Long-term use of corticosteroids and certain other medications.
- Lifestyle Factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle.
- Medical Conditions: Chronic kidney disease, hyperparathyroidism, and gastrointestinal disorders.
Diagnosis and Treatment Options
Diagnosing osteoporosis typically involves a bone density scan, known as a dual-energy X-ray absorptiometry (DEXA) scan. This non-invasive test measures bone mineral density and can help identify individuals at risk of fractures. Treatment options for osteoporosis in men are similar to those for women and include lifestyle modifications, such as increasing calcium and vitamin D intake, engaging in weight-bearing exercise, and quitting smoking. Pharmacological interventions, such as bisphosphonates, denosumab, and teriparatide, may also be prescribed to slow bone loss and reduce fracture risk.
However, the article from Mediquality suggests that despite an increase in the number of men receiving treatment for osteoporosis, the condition may still be under-treated. This highlights the need for improved adherence to treatment guidelines and ongoing monitoring of bone density.
The Importance of Early Detection and Prevention
Raising awareness about osteoporosis in men is crucial for improving early detection and prevention. Healthcare providers should routinely assess risk factors and consider bone density screening for men, particularly those with underlying medical conditions or those taking medications that can contribute to bone loss. Public health campaigns can also play a role in educating men about the importance of bone health and encouraging them to adopt healthy lifestyle habits.
Addressing the misconception that osteoporosis is solely a “woman’s disease” is paramount. By recognizing the unique risk factors and challenges faced by men, we can ensure that all individuals receive the appropriate care and support to maintain strong, healthy bones throughout their lives.
Further research is needed to better understand the specific mechanisms of bone loss in men and to develop more targeted treatment strategies. Ongoing monitoring of osteoporosis prevalence and treatment patterns will be essential for evaluating the effectiveness of current interventions and identifying areas for improvement.
The next key development to watch will be the release of updated clinical guidelines for osteoporosis management, expected from the National Osteoporosis Foundation in late 2026. These guidelines will likely address the specific needs of male patients and provide recommendations for optimal screening and treatment strategies. Readers are encouraged to discuss their individual risk factors and concerns with their healthcare providers.
Related reading