Bone production is affected by both testosterone and estrogen, so both men and women can experience bone loss as they age.

When it comes to bone health and bone density, hormones help prevent osteoporosis, a condition in which bones become weak and more susceptible to breaking. Hormonal problems can be one of the causes of osteoporosis, so it is important to understand the connection between hormones and osteoporosis.

Levels of testosterone in men and estrogen in women drop with age, with the risk being higher in women. Other hormonal imbalances, including thyroid or pituitary gland problems and lower hormone production connected with eating disorders, also can harm bone health.

Testosterone and Bone Density

New research finds that low testosterone levels are strongly associated with low bone density (BMD) — even in relatively young men.

A retrospective review of bone mineral density scans performed on 235 consecutive hypogonadal men whose mean age was just 50.7 years found osteopenia in 39% of all patients and osteoporosis in 5%.

All of the men had both physical symptoms of hypogonadism and total testosterone levels below 300 ng/dL. The average duration of their condition — from the first test indicating low testosterone levels to the eventual bone scan — was 1,219 days.

The study team defined osteopenia as a femoral neck, total hip, or total spine BMD T-score between -1 and -2.5. They defined osteoporosis as a BMD T-score in any of those areas of -2.5 or less. The actual scans were performed on a single dual-energy X-ray absorptiometry machine.

Analysis designed to determine whether bone low bone density was associated with other factors such as diabetes, smoking history, or body mass index (BMI) found only a single significant tie. Higher BMI was associated with higher bone density (presumably because extra weight creates the sort of load-bearing exercise that can protect against bone changes).

TRT for Bone Density

As men age, their serum testosterone concentrations decrease, as do their bone densities. Since bone density is also low in hypogonadal men, the scientists hypothesized that increasing the serum testosterone concentrations of men over 65 years old to those found in young men would increase their bone densities.

One year of testosterone treatment significantly increased volumetric bone mineral density and estimated bone strength in men aged 65 years and older, according to data published in JAMA Internal Medicine.

Maintaining an optimal level of androgen is essential in preventing osteoporosis and its complications in elderly men.

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