For many men, weak bones don’t come from age alone. They come from a medication or an existing health condition that quietly pulls calcium out of the bones over time. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), steroid medications, antiepileptic drugs, certain cancer treatments, gastrointestinal disease, rheumatoid arthritis, low testosterone, heavy alcohol use, and smoking are all recognized risk factors for osteoporosis in men. Knowing which ones apply to you is the first step toward protecting your bones.
Warning Signs to Take Seriously
Talk to a doctor as soon as possible if you notice any of the following. These can be signs that bone loss has already progressed:
- A bone that breaks after a minor fall, bump, or everyday movement
- Losing height over time, or noticing your posture becoming more stooped
- New or worsening back pain, especially if it started suddenly
- A collapsed or compressed bone in the spine found on an imaging test done for another reason
None of these symptoms confirm osteoporosis on their own. Only a doctor can diagnose it.
Why Men’s Bone Loss Often Has an Identifiable Cause
NIAMS notes that osteoporosis is the major cause of fractures in postmenopausal women and in older men, and that men are still at risk, especially after age 70. Among men, osteoporosis is more common in non-Hispanic whites. But unlike the general age-related bone loss that affects most women after menopause, a man’s risk often traces back to something specific: a medication he’s taking, or a condition he’s already being treated for. That makes the list below worth reviewing even if you feel healthy and have no family history of osteoporosis.
Medications Linked to Bone Loss in Men
NIAMS identifies several medication categories that can increase osteoporosis risk when used long term:
- Glucocorticoids and adrenocorticotropic hormone. These treat conditions such as asthma, and long-term use is a recognized risk factor for bone loss.
- Antiepileptic medicines. Used to treat seizures and other neurological disorders, these are also linked to increased osteoporosis risk.
- Cancer medications that use hormones. NIAMS specifically names hormone-based treatments for breast and prostate cancer as a risk factor. For men being treated for prostate cancer, this is worth raising directly with the treating oncologist.
If you take any of these medications long term, that alone is a reason to ask your doctor whether your bone health should be monitored — not a reason to stop or change the medication on your own.
Medical Conditions That Raise the Risk
- Low testosterone. NIAMS states that men with conditions that cause low testosterone are at risk for osteoporosis. It also notes that the gradual, normal decline in testosterone that comes with aging is probably not a major cause of bone loss on its own — it’s testosterone loss from an underlying medical condition that carries the added risk.
- Gastrointestinal diseases. Conditions that affect how the body absorbs nutrients can interfere with calcium absorption and increase osteoporosis risk.
- Rheumatoid arthritis. This is separately identified by NIAMS as a condition associated with higher osteoporosis risk.
Lifestyle Factors That Add to the Risk
- Heavy alcohol use. NIAMS describes chronic heavy drinking as a significant risk factor for osteoporosis.
- Smoking. Smoking is identified as a risk factor for both osteoporosis and fracture.
- Age and race. Risk increases after age 70, and among men, non-Hispanic white men are at higher risk than other groups.
Risk Factor Checklist
Review this list. The more boxes that apply to you, the more worth raising bone health is at your next checkup:
- I take or have taken long-term glucocorticoid medication (such as for asthma)
- I take antiepileptic medication
- I’m being treated with hormone therapy for prostate cancer
- I have a gastrointestinal disease that affects nutrient absorption
- I have rheumatoid arthritis
- I have a medical condition that has caused low testosterone
- I drink heavily on a regular basis
- I smoke
- I’m over 70
- I’m a non-Hispanic white man
Getting Enough Calcium: The Basics
Bones lose calcium gradually starting around age 30, and the process can accelerate later in life. The Office of Dietary Supplements (ODS) sets the recommended daily calcium intake for adult men at 1,000 mg per day for ages 19 to 70, rising to 1,200 mg per day at age 71 and older. ODS also notes that the evidence on calcium supplements is mixed: some studies find that calcium, with or without vitamin D, increases bone mineral density in older adults, while others don’t, and it isn’t clear whether supplements actually prevent fractures. If you’re concerned about your intake, a doctor or registered dietitian can help you figure out whether food sources or a supplement make sense for your situation.
A Simple Decision Path
- Step 1: Check the risk factor checklist above. If none apply, general bone-healthy habits (adequate calcium, not smoking, moderate alcohol) are a reasonable baseline.
- Step 2: If one or more risk factors apply — especially a long-term medication or a condition like rheumatoid arthritis or low testosterone — mention it at your next appointment, even if you feel fine.
- Step 3: If you’ve already had a fracture from a minor fall, or you’ve noticed height loss or new back pain, don’t wait for a routine visit. Contact a doctor.
- Step 4: Let your doctor decide whether a bone density test or other evaluation makes sense based on your specific risk factors and age.
Extra Caution Groups
Bone health deserves closer attention if you fall into any of these groups:
- Men on long-term glucocorticoid (steroid) therapy for any condition
- Men receiving hormone therapy for prostate cancer
- Men with a gastrointestinal disease that affects nutrient absorption
- Men with rheumatoid arthritis or another condition causing low testosterone
- Men over 70, particularly non-Hispanic white men
Evidence Limits
NIAMS’ public health information identifies these medications, conditions, and lifestyle factors as recognized risk factors, but it does not provide a standardized bone density screening age or schedule for men the way it does for postmenopausal women. That means the right time for a man to get evaluated depends on his individual risk factors and a doctor’s judgment, not a fixed age. This article summarizes general risk factor information; it is not a substitute for a personal risk assessment from a qualified clinician.
Frequently Asked Questions
Can a medication really cause osteoporosis?
Long-term use of certain medications — including glucocorticoids used for conditions like asthma, antiepileptic drugs, and hormone-based cancer treatments — is a recognized risk factor for osteoporosis, according to NIAMS. This doesn’t mean everyone who takes these medications will develop osteoporosis, but it’s a reason to discuss bone health with your doctor.
Should I stop taking a medication if I’m worried about my bones?
No. Never stop or change a prescribed medication because of bone health concerns without talking to the doctor who prescribed it. They can weigh the medication’s benefits against the bone health risk and decide whether monitoring or other steps make sense.
Is low testosterone from aging a major cause of osteoporosis?
NIAMS notes that the gradual, normal decline in testosterone that comes with aging is probably not a major cause of bone loss by itself. The bigger concern is low testosterone caused by an underlying medical condition.
How much calcium do men need for bone health?
According to the Office of Dietary Supplements, adult men need 1,000 mg of calcium per day between ages 19 and 70, and 1,200 mg per day from age 71 onward.
Educational Disclaimer
This article is for general educational purposes only and is not medical advice. It does not diagnose any condition, recommend any treatment, or replace evaluation by a qualified healthcare provider. Never start, stop, or change any medication based on this article. If you have symptoms of a fracture or think you may be at risk for osteoporosis, talk to a doctor.
For a broader look at osteoporosis risk factors and bone density testing, see our related article on men’s bone health and osteoporosis risk factors. For more on how testosterone levels are measured, see free testosterone vs. total testosterone. For nutrient-specific guidance, see vitamin D and testosterone in men and our supplement guide for men over 50.