Current statistics indicate that males start bone mass loss later and slower than females because their bones are bigger than those in females.

Although males in 50s do not have rapid hormone changes or bone mass loss like females in menopause, males have the same bone mass loss speed as females when they turn 65 or 70 and calcium absorption will be reduced for both males and females.

In clinical perspective, we often see males with quickened bone mass loss due to abnormal living styles, such as smoking, excessive drinking, and lack of exercise. Therefore, osteoporosis is not exclusive to females. Males should still look out for risks of osteoporosis.

What can bone mass density tell us? The risk of fracture is doubled when bone mass density decrease one standard deviation. The risk of fracture for women at age of 50 with low bone mass density is twice higher than those with normal bone mass density. The risk of fracture for women with osteoporosis is nearly four times higher than those with normal bone mass density and patients with preexisting vulnerable fracture have even higher fracture risk. These principles apply to males as well.

Who Needs Bone Mass Density Test?

Caucasian and Asian women are at the highest risk for osteoporosis and related fractures. Other clinical risk factors also play an important role on osteoporosis. People with these risk factors should have further evaluation, including bone mass density test. However, not having these risk factors does not mean these people have normal bone mass density or fracture will not occur. Therefore, comprehensive bone mass density screening should be provided if possible.

Clinical Risk Factors References for Bone Mass Density Test:

• High Risk Factors:

1. Insufficient female hormone: early menopause (before age of 45), secondary long-term amenorrhea (more than a year), and primary hypogonadotrophic sexual hypofunction.
2. Steroid intake: daily intake of more than 7.5 mg of steroid for a year or more.
3. Hip fracture history in maternal family.
4. Lower body mass index (BMI < 19 kg/m²).  
5. Other disorders related to osteoporosis, such as anorexia nervosa, malabsorption, primary hyperparathyroidism, after transplant surgery, chronic kidney dysfunction, thyroid hyperthyroidism, long-term sedentary, Cushing’s Syndrome.

• Bone mass loss and/or spinal deformity proved by radiation.
• Preexisting osteoporosis related fracture, especially hips, spine, or wrist fractures.
• Shortened height, hunchback.