Osteoporosis and Sex: How Osteoporosis Can Affect Sexual Health

Osteoporosis is linked to hormone levels in the body, which can affect sexual health. Specifically, a natural lowering of the sex hormones estrogen and testosterone as we age can contribute to bone thinning and weakness.

During this time, it's not uncommon to find yourself dealing with sexual health issues like erectile dysfunction, discomfort during sex, or a reduced sex drive.

This article discusses how osteoporosis is connected to sexual health, tips on treatment options, and when to see a healthcare provider.

What Is the Connection Between Sexual Problems and Osteoporosis?

Sexual health problems, such as erectile dysfunction (ED) and vaginal dryness, can often coexist with osteoporosis. Researchers think this connection is due to the key role that sex hormones play in bone health.

One study found that osteoporosis was three times more common in males with ED than those without the condition.

Other research suggests that experiencing sexual health issues like vaginal dryness after menopause is linked to osteoporosis.

Symptoms and Gender Differences

Osteoporosis is more common in people who have lower levels of sex hormones in their bodies, as estrogen and testosterone play an important role in providing bone protection. For women, this typically happens when menopause is reached, as the ovaries are producing less estrogen. Similarly, as men age, testosterone production is reduced.

Both genders appear to be affected differently regarding how osteoporosis may impact their sexual health. More research has been published on a link between erectile dysfunction in men with osteoporosis, while fewer studies have shown a connection between female sexual dysfunction, menopause, and osteoporosis.

Men

Although men don’t develop osteoporosis nearly as often as women, research suggests that men with ED have a higher risk of osteoporosis. While many factors can play a role in developing ED, experts believe that lowered testosterone levels are a likely culprit in the case of osteoporosis.

Erectile dysfunction symptoms can include:

• Inability to achieve or trouble achieving an erection 
• Loss of erection before sexual intercourse is over
• Difficulty performing during sex
• Premature or delayed ejaculation

In one study, the group with the highest risk for osteoporosis was men aged 40 to 59 with ED. Researchers recommend that all men with osteoporosis be evaluated for ED—and that men already diagnosed with ED be evaluated for bone density issues like osteoporosis.

Women

Significantly more women experience osteoporosis than men and may also be likely to experience sexual dysfunction issues. Researchers believe this is mostly because of the significant decline in estrogen and testosterone levels around the menopause phase.

For example, it's common to experience symptoms such as:

• Vaginal dryness
• Pain during intercourse
• Lack of sexual arousal

Experts worldwide have been looking into solutions for treating osteoporosis and sexual dysfunction in women who have reached menopause. Some of the potential therapies being studied include:

• Treating with estrogen and testosterone therapy
• Using the prescription synthetic steroid drug Tibolone
• Prescribing drugs used to treat ED for men and women
• Trying selective estrogen receptor modulator drugs (SERMs) hormone therapies for breast cancer for vaginal dryness relief and increased sexual drive

More evidence is needed before these treatments may be considered, approved, and recommended for those usages in the United States. 

How Are Sexual Problems With Osteoporosis Treated?

People experiencing sexual dysfunction issues alongside osteoporosis will want to check with a healthcare provider before adjusting their routine or medications. Ensuring your osteoporosis treatment plan is on track is a good place to start.

Treatment options for osteoporosis include:

• Prescription medications, known as bisphosphonates, are often prescribed to help decrease bone loss.
• Hormone therapy can help boost estrogen and/or testosterone levels, preserving bone density. 
• Lifestyle modifications, such as diet changes to include specific nutrients and adding resistance exercises to your workout routine, can help improve bone health.
• Surgical procedures, including vertebroplasty and kyphoplasty or spinal fusion, may be recommended to treat and prevent further bone fractures. 
• Mental health therapies, like talk therapy or support groups, can support psychological well-being with an osteoporosis diagnosis.

A healthy sex life may also contribute to improved overall health. Potential treatment options for sexual dysfunction include: 

• Erectile dysfunction (ED) treatment options can involve prescription medications, testosterone replacement therapy, counseling, and lifestyle changes.
• Female sexual dysfunction treatment options might include a testosterone patch for increased sex drive, lubricant for vaginal dryness, and avoiding sexual positions that cause discomfort.
• Talk therapy for people with osteoporosis and their partners may improve their overall sexual health. Research suggests combining this method with medication helps improve ED symptoms and sexual satisfaction.

Summary

There is a connection between osteoporosis and sexual health issues, such as erectile dysfunction (ED) and vaginal dryness. Experts think the lower levels of sex hormones as we age cause bone changes that lead to osteoporosis and increase the chances of sexual dysfunction problems. People with osteoporosis experiencing conditions like ED or painful sex should check with a healthcare provider to discuss treatment options.

A Word From Verywell

Having osteoporosis is common. Experiencing sexual dysfunction issues is common, too. Just know that you don’t need to give up your sex life or physical intimacy because of this condition. Reach out to a healthcare provider to get the conversation going so you can still engage in fulfilling relationships—regardless of a physical condition like osteoporosis.