Osteoporosis in Men

Full Guideline: Osteoporosis in Men: An Endocrine Society Clinical Practice Guideline
JCEM June 2012

Nelson B. Watts, Robert A. Adler, John P. Bilezikian, Matthew T. Drake, Richard Eastell, Eric S. Orwoll, Joel S. Finkelstein

Objective:

The aim was to formulate practice guidelines for management of osteoporosis in men.

Conclusions:

  • Osteoporosis in men causes significant morbidity and mortality.
     
  • We recommend testing higher risk men [aged ≥70 and men aged 50–69 who have risk factors (e.g. low body weight, prior fracture as an adult, smoking, etc.)] using central dual-energy x-ray absorptiometry.
     
  • Laboratory testing should be done to detect contributing causes.
     
  • Adequate calcium and vitamin D and weight-bearing exercise should be encouraged; smoking and excessive alcohol should be avoided.
     
  • Pharmacological treatment is recommended for men aged 50 or older who have had spine or hip fractures, those with T-scores of −2.5 or below, and men at high risk of fracture based on low bone mineral density and/or clinical risk factors.
     
  • Treatment should be monitored with serial dual-energy x-ray absorptiometry testing.

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