Introduction

Osteoporosis and fractures represent a major public health problem, not only in women but also in men. It has been estimated that at the age of 50 years, men have a risk of approximately 12-15% of suffering an osteoporotic fracture in later life, most commonly of the vertebra, hip or forearm (Melton and Chrischilles 1992; Nguyen et al. 1996). At the age of 60 years, the risk for a non-traumatic fracture rises to 25% (Nguyen etal. 1996). In the United States, about 150,000 hip fractures occur in men each year (Poor etal. 1995). Because of their higher peak bone mass, men present with hip, vertebral body, or forearm fractures about 10 years later than women. Hip fractures in men result in a 30% mortality rate at one year after fracture versus a rate of 17% in women (Campion and Maricic 2003). Hypogonadism, i.e. androgen deficiency, has been identified as an independent risk factor for such incidences (Jackson etal. 1992). The role of androgens in bone metabolism and the effects of androgen therapy on bone tissue in hypogonadal men will be examined in this chapter.

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