ANAHEIM, CA (UroToday.com) - This study evaluated bone mineral density in young hypogonadal men attending Andrology practice, to determine risk factors and prevalence of low bone mineral density (BMD). Men who had testosterone below 350 ng/dl were offered DEXA scan.T, LH, FSH, and estradiol were evaluated. Bone density was measured using new generation Prodigy GE DEXA scanner. The age, gender , and weight adjusted BMD, T and Z scores, and WHO clinical interpretation were recorded. Thirty two men were enrolled over 12 months period, mean age: 43.5 (SD=12). Mean testosterone: 226 ng/dl (SD=77), LH: 7.3, FSH: 14.8. Twenty nine men had full set of DEXA scan results.

Thirty eight percent of our patients had low BMD. Six patients (21%) met WHO criteria for osteoporosis. Elevated FSH was predictive of low BMD in spine (p=0.017), and low estradiol was a predictor of low total BMD in the hip (p=0.008). Low BMD can affect 1/3 of young hypogonadal men presenting with infertility or sexual dysfunction. Elevated FSH is a associated with low BMD in spine.

Editorial Comment:
This interesting study demonstrates that osteopenia may occur even in younger men. Any hypogonadal man warrents further evaluation and base line bone density studies. Obviously, the treatment of hypogonadism and osteopenia must be tailored to the patients primary complaints and desires.

( ABST [1926] - Infertility: Evaluation and Therapy II)

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Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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