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"Andropause" and Osteoporosis
Submit responseToo little attention is paid to the rapid bone loss that can occur as a result of decreases in androgen production seen in men that may result from ageing or the hormone manipulation used to deprive prostate cancer cells.Peripheral testosterone conversion to estrogen still maintains the boney matrix in males as in the female. My first osteoporotic patient treated with alendronate 8 years ago was a male and presented with lumbar compression fractures. These proved refractory to alendronate and calcitonin with continued fractures. He eventually was felt to have low total and free serum testosterone levels as the cause of his ongoing fractures. This patient has been treated with IM testosterone for the past 3 years and has remained fracture free. Men should recieve timely DXA screening and a metabolic workup that includes a testosterone level. Certainly, those who have had deprivation therapy for prostate cancer will need a baseline screen since they are likely to suffer the same rapid bone loss phase seen in women at menopause.
Conflict of Interest:
None declared