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Testosterone and Bone Health in Men
Hussein Kafel1, Shehzad Basaria2
1Division of Endocrinology, Diabetes and Metabolism, Brigham and Women's Hospital, Research Program in Men's Health, Aging and Metabolism, Harvard Medical School, 221 Longwood Ave, BLI 541, Boston, MA, 02115, USA.
Current Osteoporosis Reports
|May 15, 2026
Summary
Low testosterone is linked to reduced bone mass and higher fracture risk in men. While testosterone therapy improves bone density, it hasn't shown fracture reduction, suggesting alternative treatments for high-risk individuals.
Area of Science:
- Endocrinology
- Bone Metabolism
- Men's Health
Background:
- Testosterone is crucial for maintaining the male skeleton.
- Low testosterone levels in men correlate with decreased bone mass and increased fracture risk.
Purpose of the Study:
- To examine the relationship between testosterone and skeletal health in men.
- To review testosterone's impact on bone metabolism, bone density, and fracture risk.
- To summarize findings from testosterone therapy trials regarding bone health outcomes.
Main Methods:
- Literature review of population studies on sex steroids and bone mineral density (BMD).
- Analysis of clinical trials investigating testosterone replacement therapy (TRT).
- Examination of data from major trials like TRAVERSE on TRT effects.
Main Results:
- Population studies confirm low testosterone and estradiol are associated with reduced bone mass and higher fracture risk.
- Testosterone replacement in hypogonadal men robustly improves BMD.
- Testosterone therapy in older men shows modest BMD increases, but TRAVERSE trial indicated higher fracture rates.
Conclusions:
- Testosterone significantly influences male skeletal maintenance.
- While testosterone therapy can improve BMD, it has not proven effective in reducing fracture rates.
- Hypogonadal men at high fracture risk should consider treatments with proven anti-fracture efficacy.
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