Osteoporosis in Men: Underdiagnosed and Undertreated

You probably get your cholesterol checked. Maybe even your prostate. But has anyone ever talked to you about your bones?

Osteoporosis is often called the “silent disease” for a reason: it doesn’t show symptoms until a fracture happens. What’s even more dangerous? Many men don’t even realize they’re at risk.

Despite affecting about 2 million men, osteoporosis remains heavily underdiagnosed, undertreated, and largely ignored in male patients.^1,2 That oversight can be deadly, as men are twice as likely to die after a hip fracture compared to women.³ Let’s talk about why this condition deserves more attention and what can be done to catch it early.

A Closer Look at Osteoporosis in Men

Osteoporosis is a disease that weakens bones, making them more fragile and likely to break. Although it’s most commonly associated with postmenopausal women, men account for a significant share of those affected. Each year, roughly 300,000 Americans suffer a hip fracture — and 30% of them are men.⁴

What makes male osteoporosis so concerning is that once a fracture happens, recovery can be more difficult and complications more serious. Men are twice as likely as women to die within 1 year of experiencing an osteoporosis-related hip fracture.³ Despite this, osteoporosis awareness and screening for men lag far behind.

Why Osteoporosis in Men Is Often Overlooked

One reason osteoporosis in men is underdiagnosed is simple: outdated assumptions. For years, osteoporosis was considered primarily a postmenopausal woman’s disease. As a result, many healthcare providers don’t screen men unless there’s an obvious risk factor, like a prior fracture.

A national survey found that while 90% of doctors would screen a 65-year-old postmenopausal woman, only 22% would screen a 74-year-old man with no medical history. And even among men with known risk factors, screening rates remain startlingly low.⁵

Diagnosing osteoporosis in men is further complicated by the lack of national screening guidance. While many experts support screening men over 70 or younger men with risk factors, the U.S. Preventive Services Task Force (USPSTF) currently states there’s insufficient evidence to recommend routine screening in men.⁶

This “I” grade recommendation can lead to lower screening rates and missed diagnoses. In fact, up to 95% of men hospitalized for hip fractures are discharged without any osteoporosis treatment.⁷ Until guidelines evolve, men at risk should advocate for screening and discuss bone health with their providers.

Osteoporosis Risk Factors Specific to Men

Understanding risk factors can help identify men who should be monitored more closely. Here’s a breakdown of the most significant ones:

Age: Men over 60 are at a particularly high risk due to natural bone loss that accompanies aging.⁸
Low Testosterone Levels: Testosterone plays a role in maintaining bone mass. Men with low levels due to aging, medical conditions, or treatments (like for prostate cancer) face a higher risk.⁹
Long-Term Use of Certain Medications: Corticosteroids, commonly used to treat conditions like asthma or arthritis, can reduce bone density over time.¹⁰
Chronic Diseases: Conditions like rheumatoid arthritis, gastrointestinal disorders, kidney or liver disease, and even depression are linked with higher osteoporosis risk.^11,12,13
Lifestyle Factors: Smoking, excessive alcohol consumption, poor nutrition (especially low calcium or vitamin D intake), and lack of physical activity all contribute to bone loss.¹¹
Family History: Genetics plays a role. If your parents or siblings had osteoporosis or fractures, your risk is higher.¹⁴
Previous Fractures: A history of fractures after minor incidents should always raise a red flag, even in younger men.

The Consequences of Untreated Osteoporosis

When osteoporosis isn’t caught or treated in time, the risks escalate quickly. Fractures can occur from seemingly minor events, like slipping on the sidewalk. The hip, spine, and wrist are the most common sites, and recovery isn’t always smooth.¹⁵

Hip fractures are particularly dangerous in men, who have a higher mortality rate after the injury compared to women.³Spinal fractures can lead to chronic pain, loss of height, and limited mobility.¹⁶ Overall, untreated osteoporosis can significantly reduce quality of life and independence.

Diagnostic Challenges and Recommendations

One of the biggest challenges in diagnosing osteoporosis in men is the lack of routine screening. While women over 65 are typically screened with a DXA scan, men aren’t generally tested unless they’ve had a fracture or have other serious risk factors.¹⁷

That’s why it’s so important for men — especially those over 60 or with risk factors — to speak with an ARBDA osteoporosis doctor about a bone density test. Blood tests may also help identify underlying causes such as low testosterone, vitamin D deficiency, or other metabolic issues contributing to bone loss.

Preventative Measures and Bone Health Maintenance

An ounce of prevention is worth a pound of cure. Here’s how men can take control of their bone health today:

Get Enough Calcium and Vitamin D

Aim for 1,000–1,200 mg of calcium daily and 600–800 IU of vitamin D.^18,19 These nutrients are essential for bone strength and calcium absorption.

Stay Active with Weight-Bearing Exercise

Activities like walking, jogging, tennis, or strength training help stimulate bone growth and improve balance to prevent falls.^11,20

Quit Smoking and Limit Alcohol

Tobacco and heavy alcohol use are major culprits in speeding up bone loss. Cutting back can have immediate and long-term benefits.¹¹

Talk to Your Doctor About Medications

Certain prescriptions — including corticosteroids — may harm your bones. If you’re taking any of these, speak to your doctor about any concerns.¹⁰

Screen Early If You’re at Risk

Men over 60, or younger men with the risk factors listed above, should not wait for a fracture to find out their bone health is in danger.^8,21

Schedule a Consultation with an ARBDA Osteoporosis Specialist Today

It’s never too early — or too late — to take your bone health seriously. If you’re a man who has never discussed osteoporosis with a doctor, now is the time to take that step. At ARBDA, our team of dedicated rheumatologists specializes in diagnosing and treating osteoporosis using the latest research and personalized treatment plans.

Don’t wait for a fracture to find out you’re at risk. Schedule an appointment with an ARBDA osteoporosis specialist in New Jersey today and get a clearer picture of your bone health. We’re here to support you every step of the way because strong bones mean a stronger future.

¹https://odphp.health.gov/healthypeople/about/workgroups/osteoporosis-workgroup

²https://pmc.ncbi.nlm.nih.gov/articles/PMC7924179/

³https://academic.oup.com/jbmr/article-abstract/20/3/494/7593120

⁴https://www.cdc.gov/falls/prevention/index.html

⁵https://www.endocrinepractice.org/article/S1530-891X(20)48187-X/abstract

⁶https://jamanetwork.com/journals/jama/fullarticle/2829238

⁷https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/213704

⁸https://pmc.ncbi.nlm.nih.gov/articles/PMC4592737/

⁹https://pmc.ncbi.nlm.nih.gov/articles/PMC7867125/

¹⁰https://pubmed.ncbi.nlm.nih.gov/8941496/

¹¹https://www.niams.nih.gov/health-topics/osteoporosis

¹²https://pmc.ncbi.nlm.nih.gov/articles/PMC7555655/