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.

Mature couple being intimate in bed

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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.

It's estimated that about 10 million adults age 50 and older in the United States have osteoporosis—and the condition is roughly four times as common in women as it is in 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.


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:

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.


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.

Frequently Asked Questions

  • Does osteoporosis affect your sex drive?

    Because osteoporosis is linked to lower levels of sex hormones, it's possible to experience a decreased sex drive with this condition. If this is bothersome, know that prescription treatment options are available to help boost hormone levels or target specific issues.

  • Is sex safe for people with osteoporosis?

    It's normal for people with osteoporosis to worry about how much pressure or weight their bones may be able to handle. Experts say it's generally safe to continue your regular sex life with osteoporosis. Physical movement and exercise are often part of a treatment plan. Check with a healthcare provider if you have concerns about how an active sex life may impact osteoporosis.

19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Wu CH, Lu YY, Chai CY, et al. Increased risk of osteoporosis in patients with erectile dysfunction: a nationwide population-based cohort study. Medicine (Baltimore). 2016;95(26):e4024. doi:10.1097/MD.0000000000004024

  2. Endocrine Society. Bone health and postmenopausal women.

  3. West Virginia Division of Health Promotion and Chronic Disease. Osteoporosis risk factors.

  4. Endocrine Society. Hormones and your bones: what you need to know.

  5. Wright NC, Looker AC, Saag KG, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014;29(11):2520–2526. doi:10.1002/jbmr.2269

  6. Centers for Disease Control and Prevention. Does osteoporosis run in your family?

  7. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis in men.

  8. National Institute of Diabetes and Digestive Kidney Diseases. Definition and facts for erectile dysfunction.

  9. Xu J, Wang C, Zhang Y, Xu Z, Ouyang J, Zhang J. Risk of osteoporosis in patients with erectile dysfunction: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2021;100(24):e26326. doi:10.1097/MD.0000000000026326

  10. Lang TF. The bone-muscle relationship in men and women. J Osteoporos. 2011;2011:702735. doi:10.4061/2011/702735

  11. Monash University (Australia). Preventing bone loss and restoring sexual function in women with early menopause.

  12. Ângelo ML, de Lima Moreira F, Araújo Santos AL, Nunes Salgado HR, de Araújo MB. A review of analytical methods for the determination of tibolone: pharmacokinetics and pharmaceutical formulations analysis and application in doping control. CPA. 2020;17(1):31-39. doi.10.2174/1573412916666191025143214

  13. Kim SM, Taneja C, Perez-Pena H, et al. Repurposing erectile dysfunction drugs tadalafil and vardenafil to increase bone mass. Proc Natl Acad Sci U S A. 2020;117(25):14386-14394. doi:10.1073/pnas.2000950117

  14. Martinkovich S, Shah D, Planey SL, Arnott JA. Selective estrogen receptor modulators: tissue specificity and clinical utility. Clin Interv Aging. 2014;9:1437-1452. doi:10.2147/CIA.S66690

  15. Lainé M, Fanning SW, Chang YF, et al. Lasofoxifene as a potential treatment for therapy-resistant ER-positive metastatic breast cancer. Breast Cancer Res. 2021;23(1):54. doi:10.1186/s13058-021-01431-w

  16. American Cancer Society. Tamoxifen and raloxifene for lowering breast cancer risk.

  17. MedlinePlus. Osteoporosis.

  18. National Osteoporosis Foundation. Overall health.

  19. Schmidt HM, Munder T, Gerger H, Frühauf S, Barth J. Combination of psychological intervention and phosphodiesterase-5 inhibitors for erectile dysfunction: a narrative review and meta-analysis. Sex Med. 2014;11(6):1376-1391. doi:10.1111/jsm.12520

By Cristina Mutchler
Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content.