Age and Gender

Sex hormones play an important role in regulating the growth of our skeleton and maintaining bone strength. The female hormone oestrogen and the male hormone testosterone positively affect bone health in both men and women.

Both men and women may have certain risk factors that can make them more likely to develop osteoporosis as they age.

Everyone begins to lose bone density after about age 45. Women are especially vulnerable, as their risk of fracture rises sharply after menopause due to a steep decline in oestrogen levels, which is vital for maintaining bone density. Men also experience increased risk as they age, particularly when testosterone levels begin to drop, though this typically occurs later than menopause in women.

Without prevention or treatment, about half of us will have osteoporosis by age 75. Broken bones caused by osteoporosis become much more likely in our seventies, eighties, and beyond.

Gender-affirming surgery removes the natural source of sex hormones and will result in osteoporosis unless hormone therapy, sometimes called cross-sex hormone treatment, is taken. If the level of these hormones is inadequate, the risk of osteoporosis will be increased.