Low Estrogen Levels in Men Linked to Increased
Risk for Hip Fracture
A new study has found that men with low estrogen
levels have an increased risk for future hip fracture,
and those with both low estrogen and low testosterone
levels have the greatest risk.The study, to be
published in the May issue of The American Journal
of Medicine, was conducted by Shreyasee Amin,
M.D., Mayo Clinic rheumatologist, and colleagues
studying men from the National Heart, Lung and
Blood Institute's Framingham Heart Study prior
to her career at Mayo Clinic.
The study examined 793 men who had their estrogen
and testosterone levels measured between 1981
and 1983 and no record of prior hip fracture.
They were followed until 1999. The men were categorized
as having low, midrange or high levels of each
hormone. The researchers also recorded hip fractures
not associated with high trauma occurring since
the study start. During the study, 39 men experienced
a low trauma hip fracture (for example, incurred
due to a fall from a standing height or less).
Those with low estrogen levels (total estradiol
levels below 18 picograms per milliliter) had
3.1 times the risk of hip fracture compared to
men with high estrogen levels. There was no significant
increase in hip fracture risk for men with low
testosterone levels alone. However, men with both
low estrogen and low testosterone levels had the
greatest risk, with 6.5 times the risk of hip
fracture compared to the men who had both estrogen
and testosterone levels in the high range or midrange.
This study is the first to report the link between
low estrogen and hip fracture in a study group
of men from the general population followed over
time.Though many people associate testosterone
with men and estrogen with women, men possess
both hormones, according to Dr. Amin.
who undertook this study knew that low estrogen
levels had been associated with low bone mineral
density in elderly men, but any link to hip fracture,
an important health risk in the elderly, was unknown.
Hip fractures are worrisome in the elderly, especially
in men, explains Dr. Amin. Up to 50 percent of
men require institutionalized care after the fracture.
Hip fracture also is linked to higher levels of
mortality: up to 37 percent of men die within
one year of fracture.
"These findings add further evidence to
the important role of estrogen in the bone health
of older men," says Dr. Amin. "It's
important for us to know what puts men at risk
for hip fracture so that we can better determine
how we may prevent these fractures." Currently,
no tests are routinely performed in men to determine