Maria Pease
Article by: Maria Pease
Estimated 8 minutes read
Quick summary
Testosterone production is vital for all areas of men's health, including strong bones. Studies on testosterone and bone density report a connection between low testosterone and a deterioration in bone density that can lead to fractures and osteoporosis.

Bone density isn't something you think much about when you're young. As long as you can walk, run, stand, and move freely, your bone health isn't at the top of your mind. And why would it be? But for healthy aging, bone health becomes much more critical. You want to stay strong, and bone density is vital for helping you do that. So, what is the relationship between testosterone and bone density, and why is it essential as we age?

Your bones are made up of minerals such as calcium and phosphorus. Bone density or bone mineral density (BMD) is the amount of minerals present in some regions of bone that make bones hard. (1) It's a crucial indicator of bone strength and the likelihood of osteoporosis.

Your bones constantly change as they build up and break down bone tissue, which is called remodeling. When bones break down more rapidly than they build, you can develop osteoporosis, a bone disease that occurs with a decline in bone density. 

Remodeling involves 3 types of cells. 

  • Osteoblasts lay new bone tissue.
  • Osteoclasts absorb bone.
  • Osteocytes are stages of redevelopment and reabsorption of bone growth.

But is there a relationship between testosterone and bone density? As men reach their 30s, testosterone levels begin to drop by about 1% per year, and according to research, the chances of osteoporosis increase, which can be a direct result of a decline in this hormone. (2)

What is Testosterone?

Testosterone is the primary sex hormone in males that plays a significant role in the body, especially during puberty. It's responsible for deepening the voice and facial hair, developing bone mass, regulating libido, distributing fat, developing muscle mass and strength and producing sperm in the testes.

Testosterone production is controlled by signals sent from the brain to the pituitary gland located at the base of the brain to the testes, which produce testosterone. When levels rise, signals are sent to reduce production; when they lower, signals to increase production are sent.

The Relationship Between Testosterone and Bone Density

According to a study in the National Library of Medicine, (3) 1 in 5 men over 50 will most likely experience some type of fracture. Testosterone is the hormone responsible for keeping bones healthy. Because men experience a decline starting in their 30s, it may significantly affect bone density as they age. 

A study researching the connection between low testosterone levels and bone density (4) shows that men with a deficiency have an increased risk of experiencing bone fractures and osteoporosis.

The Impact of Low Testosterone on Bone Density

The Journal of Clinical Endocrinology and Metabolism states that one of the main issues with low testosterone is a decrease in bone mineral density (BMD), which significantly increases the risk of bone and hip fractures in men.

Because bone breaks down naturally as you age, when testosterone levels are too low, the bone can't grow back efficiently, resulting in weak and brittle bones and the possibility of osteoporosis. This can significantly increase the risk of accidents and falls, leading to more severe issues. Studies link the decrease in bone density to low testosterone. (5)

Symptoms of low testosterone include:

  • Low sex drive
  • Erectile dysfunction
  • Low sperm count
  • irritability
  • Loss of muscle mass
  • Increase in fat, especially around the middle
  • Thinning hair
  • Low energy
  • Loss of motivation

While low testosterone can interfere with day-to-day activities, it can also have long-term effects on men's health, such as heart disease and bone loss. (6)

How Testosterone Replacement Therapy Can Help

A common type of hormone replacement therapy called Testosterone replacement therapy (TRT) treats men with testosterone deficiency. It's only available via prescription from a medical professional, restoring hormone balance and easing the symptoms of low T.

For men who suffer from low T and experience symptoms, TRT offers a variety of benefits that include:

Reduced fat

There are enzymes in belly fat called aromatase that convert testosterone into estrogen, leading to an increase in fat and slowing metabolism. TRT can reverse the cycle by balancing hormone levels and reducing belly fat.

Increased muscle

Testerone is a significant factor in building muscle, so when levels begin to decline in the 30s, metabolism slows down, and fat increases. TRT helps to rev metabolism, decrease fat and increase muscle strength.

Improved sexual function

One of the most common issues with low T is the loss of libido, which may be related to low energy, increased fat, and loss of muscle mass. All factors are related to confidence and feelings of desire. Testosterone replacement can give you energy, increase muscle, burn fat and increase your sex drive.

Improved bone density

As men age and testosterone levels drop, men have a higher risk of low bone density loss. Evidence shows a clear link between testosterone and bone density. According to studies (7), TRT increases bone density and strength in men with low T and bone mineral density.

Although testosterone is mainly associated with a man's sex drive, it's also vital for all areas of health and well-being. Testosterone affects bone health, muscle mass, fat storage, red blood cell production, and mental health. Low levels can interfere with both physical and psychological health.

If you're experiencing signs of low T, Testosterone therapy may be able to help you regain the energy and strength you once had. It's best to contact a healthcare provider for a medical consultation to assess hormone levels. Make sure to choose a provider that offers the latest in patient care and looks at hormone health as a whole. Testosterone, thyroid, vitamins, diet and fitness help maintain healthy bones and prevent broken bones as you age. 

Close up of bones and bone density.

Other Factors Affecting Bone Density

Estrogen and Your Bones

Testosterone and bone density are not exclusively connected. Estrogen, often associated with women, also plays a role in bone health in men. Men produce small amounts of estrogen by converting testosterone into estrogen via an enzyme called aromatase. 

Here's how estrogen influences bone health in men:

Bone Density Maintenance: Estrogen helps maintain bone density in men by promoting bone formation and reducing the breakdown of bone tissue.

Hypogonadism: Low testosterone levels can lead to decreased estrogen levels in men. This can result in a decrease in bone density, similar to what is seen in postmenopausal women.

Aging: As men age, their testosterone levels naturally decline, which can result in reduced estrogen production. This age-related change contributes to a gradual decline in bone density and an increased risk of osteoporosis and fractures in older men.

Medical Conditions and Medications: Certain medical conditions and medications can lead to hormone imbalances, including estrogen, which can affect bone health in men. For example, men with prostate cancer who undergo androgen deprivation therapy (ADT) may experience a significant decrease in testosterone levels and an increased risk for bone loss. Much like men who take estrogen blockers (aromatase inhibitors) like anastrozole, they may also experience bone loss, erectile dysfunction and memory issues.

Treatment Options: In some cases, men with low bone density or osteoporosis may be prescribed medications such as selective estrogen receptor modulators (SERMs) or bisphosphonates to help improve bone density. These medications can have estrogen-like effects on bone tissue.

While estrogen's role in bone health in men is less prominent than in women, it still plays a crucial role in maintaining overall skeletal health. Men can also experience bone-related issues related to estrogen imbalances, aging, medical conditions, and certain medications. 

Other Factors

Bone health is vital for strength and balance, supporting the body's weight, enabling you to move about, stand up straight and feel younger. Knowing the factors that can interfere with bone health is essential to keep bones strong. They include:

  • Drinking excess amounts of alcohol
  • Smoking
  • Age
  • Being overweight
  • Hormonal changes
  • Lack of physical exercise
  • Poor diet
  • Lack of essential nutrients, vitamins, and calcium
  • Health issues and disease

To keep bones strong and healthy, lifestyle plays a big part and is something you have control over. A high-nutrient diet and regular physical exercise, while limiting unhealthy habits, can increase your chances of strong bones and reduce bone fracture and osteoporosis risk. 


Although research continues to examine the connection between bone density and testosterone, several studies show that low levels have a negative effect on bone density. Low T increases the chances of bone fractures, hip fractures and osteoporosis. If you suffer from low testosterone, TRT can help strengthen your bones and restore a life you enjoy.

Man stretching leg after a run.

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