Osteoporosis and Erectile Dysfunction in Men

Research now connects osteoporosis in men with erectile dysfunction (ED). In fact, according to a large nationwide study from Taiwan, men with osteoporosis should be evaluated for ED and men with ED should be screened for low bone mass density.1

Erectile dysfunction is a common problem in men with a range of potential causes and contributing factors (eg, stress), yet many people do not equate osteoporosis as a man’s disorder. However, as men live longer, their skeletons, like womens are susceptible to bone loss that can lead to painful spinal vertebral compression fractures. That’s why it’s important for men to understand their osteoporosis risk and get the right treatment before they break a bone.

osteoporosis infographicOsteoporosis infographic tells the story about this bone metabolic disease that affects both men and women.

Osteoporosis and Erectile Dysfunction Study Outcomes

Researchers have revealed another risk factor connecting men and osteoporosis—erectile dysfunction (ED). In 2016, researchers published a study that found that ED is an early predictor of osteoporosis.

How did the researchers explain the link between ED and bone loss?
“First, patients with ED have lower naturally available free testosterone than those without ED,” said the study’s co-author Chih-Lung Lin, PhD. “Androgens [male sex hormones, like testosterone] may play a critical role in the regulation of bone formation in men.”

Dr. Lin also said ED is closely associated with inflammation, which promotes bone cell dysfunction. When bone cells don’t form new bone and remove old bone in a balanced way, it can lead to osteoporosis. Additionally, Dr. Lin noted that “Lower vitamin D levels lead to substantial losses in bone mass, eventually causing osteoporosis.”

Lastly, he connected a reduction of nitric oxide bioactivity—a molecule that plays a role in several body systems, from bone formation to reproductive health—is a possible explanation for the relationship between ED and osteoporosis.1

If you have osteoporosis, talk to your doctor about your risk for ED. And if you have ED, proactively discussing a bone mineral density test with your doctor can give you a clear picture of your bone health—and help you address bone loss before you experience a painful fracture.

Osteoporosis in Men: Risk Factors Include Erectile Dysfunction

Certain risk factors have been long linked to osteoporosis in men. If any of the following apply to you, you may be at an increased risk of developing osteoporosis:

  • Aging (your risk increases as you get older)
  • Race (Caucasian men have a higher risk than men of other races)
  • Chronic use of glucocorticoids (such as prednisone, an oral steroid)
  • Undetected low levels of testosterone
  • Smoking
  • Alcohol abuse
  • Sedentary lifestyle
  • Lack of calcium in your diet
  • Chronic kidney, lung, gastrointestinal, or stomach conditions, and diseases that alter hormone levels 

Cutting the Confusion: 3 Questions About Men and Osteoporosis

Clearing up the misconception that osteoporosis is exclusively a woman’s disease begins with answering some basic questions about how the disease affects men and women.

Why do men develop osteoporosis less often than women?
Men develop osteoporosis at a lower rate than women for 4 main reasons:

  1. Men have bigger skeletons (more bone mass)
  2. Men don’t go through a sharp hormonal shift that triggers bone loss (menopause)
  3. Male bone loss begins later in life
  4. Bone loss in men occurs slowly

But those 4 reasons don’t safeguard men from the disease. Any man can develop osteoporosis.

Menopause often sparks bone loss in women—when do men typically see a reduction in bone mass?
By around age 65 or 70, men catch up to women in losing bone mass. At that point, both sexes struggle with absorbing calcium.

Age clearly plays a role in men’s risk for osteoporosis, but what else causes the disease in men?
Most men with osteoporosis develop the condition as a result of aging, but they also have a “secondary” cause—a lifestyle choice, separate condition, or medication that contributes to the development of osteoporosis, and now erectile dysfunction. Common secondary causes include alcohol abuse, smoking, glucocorticoid use (these medications cause bone loss), low testosterone levels, gastrointestinal disease, and prolonged bed rest or immobilization of a body part.

How Strong Are Your Bones? Get the Real Answer in an Osteoporosis Screening

While women often get screened for low bone mass at midlife, men often learn they have osteoporosis after they break a bone. But osteoporosis can be effectively managed before you experience a painful fracture. That’s why being proactive about your bone health is so important.

The National Osteoporosis Foundation says men should get a bone density test if they:2

  • Are 70 or older
  • Had a fracture and are older than age 50
  • Have risk factors and are between age 50 and 69
  • Lost a half-inch or more of height in a year
  • Lost 1.5 inches of total height in their lifetime

Getting screening for osteoporosis is quick and painless. Your doctor will gather your medical history and take laboratory tests (blood and urine). While your doctor may order an x-ray initially, he or she will likely also order a bone mineral density test to get a total picture of your bone health.

A bone mineral density test, also called a dual-energy x-ray absorptiometry, or DEXA or DXA test, provides a picture of the bone mass in your hip and spine. Your doctor may also use the results of the FRAX® fracture risk assessment to craft an osteoporosis prevention or treatment plan.

Osteoporosis Treatment Options for Men

If you learn you have osteoporosis or are at a heightened risk for developing it (a condition called osteopenia), your doctor will discuss your treatment options with you. Combatting bone loss typically takes several components—a combination of lifestyle changes (like following a bone-boosting diet and exercising) and prescription medication.

When it comes to osteoporosis medications, men have different options than women. The following drugs are approved to treat bone loss in both men and women, but this is not an exhaustive list. Pharmaceutical companies are continuously advancing osteoporosis drug therapy, and your doctor may present you with a newer therapy not listed here.

The following medications belong to a class of osteoporosis drugs called bisphosphonates:

  • Alendronate, alendronate plus Vitamin D (Fosamax, Binosto)
  • Risedronate, risedronate with calcium (Actonel)
  • Zoledronic acid (Reclast)

The following medications are a new class of osteoporosis medications called anti-RANKL drugs (RANKL = Receptor Activator of Nuclear Factor-κB Ligand). These drugs reduce bone turnover to boost bone mass:

  • Denosumab (Prolia, Xgeva)
  • Teriparatide (Forteo)
  • Parathyroid hormone (anabolic)

Osteoporosis and Erectile Dysfunction: Know Your Risks

The belief that only women develop osteoporosis is a dangerous misconception. If you have any of the risk factors outlined in this article, which may include erectile dysfunction, talk to your doctor about getting screened for bone loss. That simple step will arm you with a clear picture of your bone health—and could be the thing that prevents a painful vertebral fracture in your spine.

Updated on: 06/12/18
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