Feature Article

Osteoporosis and low-trauma fracture in men

Chris Gilfillan

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Abstract

Given that about 20% of all individuals with osteoporosis defined on WHO criteria are men, awareness of the risk factors and appropriate management strategies for such patients are essential.

Key Points

  • Osteoporosis is a significant clinical problem in men.
  • Roughly 400,000 men in Australia have osteoporosis. About 27% of men aged 60 years will have an osteoporotic fracture during their remaining life.
  • Mortality and morbidity following osteoporotic fracture may be greater in men than in women.
  • Secondary causes play a significant role in the development of osteoporosis in men.
  • Management includes identifying and treating secondary causes of osteoporosis and encouraging adequate calcium and vitamin D intake and regular weightbearing exercise.
  • Testosterone replacement therapy is recommended for patients with established hypogonadism, but testosterone supplementation of normal ageing men remains controversial.
  • Pharmacological interventions of proven benefit include bisphosphonates and, in selected patients, teriparatide.

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