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Testosterone and Osteoporosis

What you can do to prevent osteoporosis

Testosterone deficiency and bone loss in men


  • Treating osteoporosis in men is usually through lifestyle improvements such as diet, exercise, and medication.
  • It is known that menopausal women require estrogen to maintain bone health, and the same applies to men!
  • During male andropause, testosterone levels decline, knocking down estrogen, thereby reducing any protective benefits, reducing bone rejuvenation and bone mineral density (BMD).
  • By replacing lost hormones, you can halt the onset of osteoporosis, improve BMD and reduce the risk of fractures.

Start Hormone Replacement Therapy today by completing a free hormone assessment!

“The prevalence of osteoporosis in testosterone deficient males is double that of those with normal testosterone level.”

Nazem Bassil, Saad Alkaade, and John E Morley. Ther Clin Risk Manag. 2009

What causes osteoporosis?

The health of our bones is reliant on a complex process called remodeling. This process relies on three main types of bone cells called bone-reabsorbing osteoblasts, bone reabsorbing osteoclasts, and mediator osteocytes. These cells are sensitive to signals received via hormones, cytokines, minerals, and to what you eat.

If there is any disruption to this remodeling process, the rate of bone formation is slower than resorption, leading to bone mineral density loss. Andropause-associated hormonal changes, age, changes in physical activity, alcohol, smoking, drugs, and diseases can all disrupt this crucial physiological process.

The potential for developing osteoporosis usually begins during the first 30 years of a man’s life, during which time you are growing and strengthening your bones. This means that preventative measures during younger life should be taken and maintained during later life, such as:

  • Diet and nutrition: Calcium and vitamin D4 are important for your bones. It is also important to avoid foods with high salt content, caffeine, or lots of protein which potentially reduces calcium absorption.
  • Smoking and alcohol abuse: Smoking and, in particular, excessive alcohol consumption can significantly damage bone health.
  • Exercise: Weight-bearing exercises increase bone strength. Exercise also improves balance and overall strength, reducing the risk of falls.
  • Maintain optimal hormones: Testosterone levels naturally decline from around 35 onwards. Testosterone and estradiol play a central role in maintaining bone health, so testosterone replacement therapy can restore your hormone balance and improve bone health.

Take a free assessment to evaluate your hormone levels

Symptoms of low bone mass and low testosterone

The problem with osteoporosis is that many men don’t even realize they have it until a fall or a break. BMD reduces gradually over many years, and the symptoms are not openly obvious, but there are certain signs to look out for:

  • The most obvious sign is broken bones: Fractures involving little force are a sign of weakened bones. Breaks are most common in the wrist, hips, and spine.
  • Loss of height: This could imply that the bones in your back are weakening. The vertebrae can become thin and start to collapse, resulting in a gradual loss of height.
  • Neck and back pain: Again, this could be due to compression and fractures in the spine.
  • Stooping and hunched posture: Due to bones becoming weak, it can be difficult for people with osteoporosis to stand up straight.

Estrogen and bone health

Estrogen is considered the ‘female sex’ hormone, and this is true, but estrogen also plays an integral role in both male and female bone health. Interestingly estrogen levels in aging men are higher than those of postmenopausal women, which may explain why women are more likely to develop osteoporosis.

Estradiol (a form of estrogen) is a by-product of testosterone via a process called aromatization. So, if your testosterone falls below optimal levels, your estradiol will as well, reducing the protective benefits these hormones offer. Studies show that estradiol is a key hormone in the maintenance of bone health. Even young men with estrogen resistance or those with aromatization problems show reduced bone mineral density (BMD), suggesting a crucial role for estradiol in the regulation of skeletal growth in men. Moreover, serum levels of both estradiol and testosterone are directly linked to the risk of fracture in aging men.

Furthermore, this highlights why aromatase inhibitors that block testosterone conversion into estradiol are actually harmful. Studies [6] show the administration of aromatase inhibitors over a period of 12 months resulted in a decrease in BMD. Thus, highlighting the important role of estrogens and androgens in male bone remodeling. 

Testosterone replacement therapy improves bone density

Testosterone replacement therapy (TRT) is traditionally only offered to men with significantly low testosterone levels to combat a condition called hypogonadism. TRT is used to treat a wide range of symptoms such as metabolic syndrome, obesity, sexual dysfunction, and bone mineral loss.

The benefits of bioidentical hormone replacement therapy:

  • Improved libido and sexual satisfaction
  • Reduced osteoporosis risk
  • Reduced bad cholesterol (LDL)
  • Increased metabolism
  • Improved cardiovascular health
  • Increased lean muscle mass and strength
  • Decreased body fat (dangerous visceral fat)
  • Increased confidence, positivity, memory, and brain function
  • Reduced feelings of depression
  • Increased energy levels
  • Improved sleep
  • More equipped to deal with stress
  • Reduced risk of type 2 diabetes and relief from insulin resistance

Through a combination of diet, exercise, supplements, and testosterone replacement therapy it is possible to limit and even reverse the damage caused by osteopetrosis. The best form of defense is to get your hormone levels checked before the damage is done and maintain optimal hormone levels.

Take the first step to restoring your vitality by completing an online hormone assessment.

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