Bone loss in men: Pathogenesis and therapeutic considerations

Osteoporosis has traditionally been a disorder almost synonymously associated with women, and as a result our understanding of osteoporosis in men is rudimentary. Nevertheless, there is an emerging recognition of the impact of osteoporosis in men. Attention is now being focused on elucidating the causes of age-related bone loss and delineating the clinical character and pathophysiologic processes responsible for idiopathic male osteoporosis. Of particular importance are efforts to understand the basic nature of the sexual differences in skeletal development and maturation, with the aim of identifying gender-specific aspects of male skeletal metabolism. Recognition of the factors re-sponsible for the fracture protection inherent in the male skeletal phenotype may afford new therapeutic approaches for both male and female osteoporotic patients. The purpose of this review is to summarize our current understanding of osteoporotic bone disease in men and provide a framework for diagnostic and therapeutic approaches to this disorder.