Geriatrics grand rounds: Eve's rib, or a revisionist view of osteoporosis in men

It is widely accepted that estrogen withdrawal following menopause predisposes women to accelerated bone loss and increased risk of developing osteoporosis. Although osteoporosis is a significant public health problem for aging men as well as women, the cause of osteoporosis in men remains largely u...

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Bibliographic Details
Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2000-10, Vol.55 (10), p.M560-M569
Main Author: Katz, M S
Format: Article
Language:English
Subjects:
Aged
Aging - blood
Bones
Estrogens
Estrogens - physiology
Female
Gonadal Steroid Hormones - blood
Humans
Hypogonadism - complications
Hypogonadism - etiology
Male
Men
Models, Biological
Older people
Osteoporosis
Osteoporosis - complications
Osteoporosis - drug therapy
Osteoporosis - etiology
Testosterone - blood
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Summary:It is widely accepted that estrogen withdrawal following menopause predisposes women to accelerated bone loss and increased risk of developing osteoporosis. Although osteoporosis is a significant public health problem for aging men as well as women, the cause of osteoporosis in men remains largely unknown. A substantial number of men with osteoporosis present with bone loss secondary to conditions associated with reduced gonadal steroid hormone levels. Although hypogonadism is related to bone loss in men, and androgen levels decline with age in men, it is not at all clear that reduced androgen levels are related to bone loss in older men. What, then, is the role of gonadal steroids in osteoporosis in men? This review focuses on recent research--including clinical investigations of men with genetic disorders of estrogen action, basic biomedical studies of estrogen receptor "knockout" mice, and population-based comparisons of bone density with gonadal steroids in older men--leading to the surprising conclusion that estrogen plays a vital role in maintenance of bone in men as well as in women. Possible mechanisms whereby reduced estrogen levels might result in bone loss in both sexes are also reviewed, as are potential therapeutic implications of a role for estrogen in osteoporosis in men.
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/55.10.M560