OBJECTIVE: To review information pertinent to bone health and osteoporosis in 
men.
METHODS: A review of pertinent literature was conducted.
RESULTS: Osteoporosis affects approximately 2 million men in the US and accounts 
for an estimated 600,000 fractures each year. There are significant differences 
in skeletal size and structure between men and women that account for 
differences in fracture incidence, location, and outcomes. Bone density testing 
is appropriate for men age 70 and older and younger men (50-69) who have risk 
factors for osteoporosis. Lifestyle management, including adequate calcium and 
vitamin D intake, appropriate physical activity, and avoidance of tobacco and 
heavy alcohol use, is appropriate for all men. Pharmacologic therapy to reduce 
fracture risk is advisable for men with a clinical diagnosis of osteoporosis (a 
spine or hip fracture) or a T-score of -2.5 or below in the spine, femoral neck, 
total hip or 1/3 radius; however, the majority of men at high risk will only be 
identified using a fracture risk assessment tool, such as FRAX. Alendronate, 
risedronate, zoledronic acid, denosumab, and teriparatide are Food and Drug 
Administration (FDA)-approved therapeutic options.
CONCLUSIONS: Osteoporosis in men presents an important public health problem 
with significant morbidity and mortality. There are recommended strategies for 
identifying men at high risk of fracture, and effective agents are available for 
treatment.