Testosterone: It’s Not Just About Sex It’s About Bone Strength
When most guys hear “low testosterone” or “Low T,” they think fatigue, low libido, or maybe muscle loss. But here’s something most men don’t realize:
Low testosterone is one of the leading but often overlooked causes of bone loss in men.
Men with untreated Low T are at a significantly higher risk of osteoporosis and fractures, especially after age 40. And the consequences go beyond a broken hip; they can impact your long-term strength, independence, and lifespan.
How Low Testosterone Affects Bone Density
Testosterone helps regulate osteoblast activity in the cells responsible for building and maintaining strong bone. When T levels drop, bone remodeling slows, and you start losing bone faster than your body can rebuild it.
Studies show:
- Men with low testosterone have up to 3x higher risk of developing osteoporosis [¹]
- Up to 50% of men with hip fractures have undiagnosed low T [²]
- Bone Mineral Density (BMD) improves significantly in men undergoing Testosterone Replacement Therapy (TRT) [³]
Low T isn’t just a hormonal issue, it’s a structural one. It can silently weaken your skeleton, making you vulnerable to stress fractures, falls, and joint pain.
Why DEXA Scans Matter
If you’re over 40 and have symptoms of Low T or you’re on TRT you need to know your bone density status. That’s where the DEXA scan comes in.
What’s a DEXA scan?
- Stands for Dual-Energy X-ray Absorptiometry
- Measures Bone Mineral Density (BMD)
- Detects osteopenia and osteoporosis before fractures happen
It’s non-invasive, painless, and takes about 10 minutes. Most importantly, it gives you hard data about your bone health and lets your medical team track how your bones are responding to treatment over time.
Who Should Get a DEXA Scan?
Men should consider a baseline DEXA scan if they:
- Have confirmed or suspected Low T
- Are over 40, especially if they’ve had fractures or are losing height
- Are starting or already on Testosterone Replacement Therapy (TRT)
- Have a family history of osteoporosis
- Use corticosteroids, smoke, or drink heavily
Routine bone density testing every 1–2 years is crucial for any man managing Low T, to monitor changes and adjust therapy as needed.
TRT: Can Testosterone Actually Restore Bone Strength?
Yes.
In a clinical trial, TRT increased spine bone density by 7–10% over two years in older men with low T [⁴]. Other studies show similar results for the hip, femoral neck, and pelvis, areas where fractures can be life altering and have devastating effects on all cause mortality rates.
BUT: Bone gains from TRT require consistency and monitoring. That’s why pairing therapy with DEXA tracking and hormone labs is the gold standard.
References:
- Center JR et al. (1999). Low testosterone predicts increased fracture risk in elderly men. J Clin Endocrinol Metab.
- Wu FCW et al. (2008). Hypogonadism and bone health in aging men. Aging Male.
- Snyder PJ et al. (2000). Effect of testosterone treatment on bone mineral density in men over 65. J Clin Endocrinol Metab.
- Snyder PJ et al. (2017). Effects of testosterone treatment in older men. NEJM.
- National Osteoporosis Foundation. Osteoporosis in men: fact sheet.
