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


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


  • 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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