Endocrine Abstracts

Several wrong conceptions persits with respect to male osteoporosis which unfortunately lead to under- diagnosis as well as under- treatment of this disease. Osteoporosis is still considered a female disorder. However, osteoporosis is not a rare condition especially in elderly and/or hypogonadal men. Moreover, fractures in elderly men are even more strongly associated with mortality than in women. Most of the risk factors for osteoporosis are also similar in men compared to women. These risk factors are easily identified but remain still insufficiently recognized. Dual energy dual energy absorptiometry is also a useful additional tool for the diagnosis of male as well as postmenopausal osteoporosis despites gender differences in bone structure. Reduction of fracture risk as result of antiresorptive as well anabolic anti-osteoporotic therapy is less well established in men than in postmenopausal women. Available data however indicate the outcome of anti-osteoporotic treatment in men at high risk for osteoporosis is not different from women. Therefore, current therapeutic lethargy in men at risk of fractures is not justified. The efficacy of testosterone supplementation with respect to prevention and treatment of osteoporosis however is less well documented in these men. In this lecture a practical approach for management of men with low and borderline low testosterone levels will therefore be presented with specific reference to a recent guideline on this topic of the European academy of andrology.