Osteoporosis and sex steroids

With increasing longevity, the maintenance of good health is pivotal for independent living in the elderly. Osteoporotic fractures are a crippling occurrence in their lives and are an obvious impediment for most of the activities of daily living. Osteoporotic fractures have long been regarded as a female ailment, but with the increasing longevity of men, it appears that the incidence and prevalence of osteoporotic fractures in men is not very different from the rate in women, although it occurs approximately 10 years later in the lives of men when their general health is deteriorating. A multitude of factors determine bone strength: genetic, nutritional (calcium), vitamin D (both nutritional or exposure to sunlight), physical activity, and hormonal factors. Hormonal factors are significant throughout life, from puberty onwards. In adolescence they are indispensable for the formation of peak bone mass. Throughout life, sex steroids maintain bone formation. Surprisingly, in men estrogens appear to be more significant for the development of peak bone mass and the maintenance of bone mineral density than androgens. In men estrogens are derived from androgens and levels of estrogens and androgens are strongly interrelated and adequate androgen levels imply adequate estrogen levels.