Low Testosterone & Your Risk for Osteoporosis: How Does It Affect Your Bones?

Hypogonadism has been linked to various medical conditions and can significantly affect and reduce a patient’s quality of life. While more common symptoms like fatigue and decreased libido are better-known consequences, low testosterone and osteoporosis have also been linked.

What does that mean?

It means that the male hormone testosterone has a multifaceted and wide reach — one that can surpass the most commonly expected symptoms. Depending on your age, osteoporosis can profoundly impact your life, reducing your overall bone mineral density (BMD) and increasing your likelihood of fractures.

Osteoporosis prevention is closely tied to hormonal factors — in fact, many of your hormones contribute to bone health. This means that keeping your hormones, including your testosterone, balanced, can help you achieve healthier and stronger bones.

Why Care About Bone Health?

Remember how you were told to “drink your milk” and “eat your veggies” when you were little? This is because they can strengthen your bones and help you grow. Bone health is critical in protecting your organs from injury — making them a supportive framework for your body that enables you to move around safely.

Maintaining healthy bones also alleviates your risk of fractures and as we get older and falls become more frequent, it’s imperative you keep your BMD in check. 

But what is your BMD or bone mineral density? A BMD will quantify the minerals in your body, including calcium. This is important because the more minerals in your bones, the denser and better their quality — after all, stronger bones are less likely to break, keeping your organs safe and allowing you to move around more freely.

What is Osteoporosis?

Osteoporosis is a sign of declining bone health and a disease that can impact both your bone mass and bone mineral density. It can also alter the strength and structure of your bones. Less bone strength translates into a higher risk of fractures, which gains significance as you age.

More often than not, osteoporosis doesn’t have any obvious disease symptoms because bone decay will happen underneath the surface. It can affect both genders, all races, and all ethnicities. 

Osteoporosis can be drug-induced and can be triggered by an array of different medications:

  • proton pump inhibitors  (PPIs), 
  • selective serotonin receptor inhibitors (SSRIs), 
  • thiazolidinediones (TZDs),
  • medroxyprogesterone acetate (MPA),
  • chemotherapy,
  • and anticoagulants.

With osteoporosis symptoms being mainly “silent,” fractures can be used as a sign of reduced BMD. Spinal fractures can further lead to back pain and expose osteoporosis by bringing symptoms to the surface. Other symptoms may include spine malformations and a loss in height.

What Causes Osteoporosis?

Osteoporosis can be a consequence of underlying chronic medical conditions, the frequent use of certain medications, hormonal factors, as well as poor eating habits and lifestyle choices, such as smoking and the excessive consumption of alcohol.

Some of the disorders that can contribute to osteoporosis include rheumatoid arthritis, diabetes, Parkinson’s, and other neurological diseases. Advanced age is a further variable that can automatically impact your bone density.

And then there are hormonal imbalances that can throw our bodies into chaos. This includes low testosterone which can promote the development of osteoporosis.

Osteoporosis and Hormonal Factors: What Role Do Your Hormones Play?

Your endocrine system is a key player in ensuring that your body has enough of the hormones it needs to function at its full potential. It constitutes multiple glands and organs that are responsible for secreting and handling hormones. With hormonal factors capable of triggering osteoporosis, it’s imperative that you pay attention to the needs of your endocrine system.

Hormones are critical for your bone health and maintaining the strength and structure of your bones. Statistics just reiterate HOW important bone health really is — after all, 10 million Americans suffer from osteoporosis, with a whopping 44 million at risk for developing the disease.

One of these crucial hormones for your body is your sex hormone, meaning that low testosterone can go hand-in-hand with osteoporosis. Let’s find out how they’re connected.

Low Testosterone and Osteoporosis

In men, low testosterone is one of the biggest risk factors for osteoporosis. It becomes most likely as you advance in age — with the latter being a factor that can naturally lead to declining bone density. 

A review of multiple studies confirmed a direct effect of testosterone on your bone health. 

Testosterone’s primary role is to:

  1. stimulate osteoblasts to construct bone, 
  2. while simultaneously supporting osteocytes to preserve bone mass.

Given the importance of testosterone, both primary and secondary hypogonadism can cause a decline in BMD and increase your fracture risk. This means that low testosterone has a significant impact on bone and is a direct trigger of osteoporosis.

It further indirectly affects bone, converting aromatase into estrogen — with changes in aromatase activity potentially leading to bone loss in males.

Other Hormones and Osteoporosis

Low testosterone is not the only hormonal issue that can result in osteoporosis. In fact, osteoporosis has been associated with various hormonal factors that can plague your endocrine system. 

Malfunctions in your pituitary gland or tumors in the adrenal gland can lead to the overproduction of cortisol — also known as the “stress hormone.” The excessive presence of cortisol can then lead to the development of Cushing’s syndrome and adversely affect your bones

Other hormonal factors contributing to osteoporosis are imbalances in your thyroid hormone or an increase in the production of prolactin in the pituitary gland. Hyperprolactinemia, in turn, is known to increase the risk of osteoporosis due to its ability to reduce BMD.

Osteoporosis Prevention: What Can You Do?

Preventing osteoporosis is imperative, particularly in light of the many hormonal factors that can interplay and adversely affect your bone health. 

Know that despite hormonal fluctuations, you can work towards osteoporosis prevention by maintaining a healthy lifestyle — consuming foods with plenty of vitamin D and calcium, engaging in strength training, and avoiding tobacco products and excessive alcohol use.

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