Remember that feeling of pride when you finally hit your full adult height? Maybe it was 5’10”, maybe a towering 6’2”. You stopped growing, started filling out, and that number became a part of who you were. But fast forward a few decades, and suddenly the numbers are creeping down. An inch here, half an inch there. Why?
Shrinking with age is often a red flag from your bones. And for men, one possible reason behind this could be to do with your hormones.
Does testosterone really affect height?
Not directly. You’re not going to wake up one morning with a venous blood test showing lower testosterone and find yourself a couple of inches shorter. But alongside sexual maturity and a range of other factors, testosterone does play a role in maintaining bone strength throughout your life.1 When testosterone levels dip as they naturally do with age, it can quietly eat away at your bone density. Over time, that bone loss can lead to osteoporosis (loss of bone density), compression fractures in the spine, and yes, visible height loss.1
Understanding height loss: what’s normal?
It’s normal for people to lose a bit of height as they get older. Starting in your 40s, most men lose about 0.4 inches (1 cm) of height per decade. Gravity wears down the discs in your spine, muscles weaken, and posture can subtly shift.2
But significant height loss (anything more than 2 inches) may point to something more serious, like osteoporosis.1,2 For men, osteoporosis is often overlooked, because it’s wrongly assumed to be a disease solely associated with menopause.3 For instance, in a large study of over 2,000 women, those who lost at least 2 inches of height had up to 9.6 times the risk of having osteoporosis at the hip compared to those who lost less than an inch.4 Though the study focused on women, the link between height loss and bone weakness applies to men, too, especially those with low testosterone.
The testosterone-bone connection
Testosterone helps stimulate bone formation and slows bone resorption (the process where bone is broken down).1 It does this in two ways: directly, by binding to androgen receptors in bone cells like osteoblasts and osteocytes, and indirectly, by converting to oestrogen via an enzyme called aromatase.1 That oestrogen (yes, in men too) plays a role in keeping bones dense and strong.
When testosterone levels fall too low - a condition known as hypogonadism - bone-building slows, bone breakdown speeds up, and the result is often osteoporosis.5,1
Though you might think that if that’s true, then all older men should develop osteoporosis, but it isn't quite like that. While all men lose some testosterone with age, some experience more dramatic declines, either from medical conditions (like pituitary disorders or cancer treatment) or simply due to age-related hypogonadism.1 For these men, bone loss can accelerate quickly.
How does osteoporosis affect men?
About 1 in 5 men over 50 will break a bone due to osteoporosis, and hip fractures in men are more deadly than in women.6 What’s more worrying is that osteoporosis often goes undiagnosed in men until a fracture occurs.7 Male osteoporosis is under-recognised in part because we’ve traditionally used bone density scores based on female populations. But even with this bias, research shows that hypogonadism is a major contributor to male osteoporosis, accounting for up to 30% of cases.1
How do I know if I’m at risk?
First, pay attention to your height. Have you lost an inch or more since your 20s?
Next, consider your risk factors:1,5
Low testosterone or symptoms of low T (fatigue, low libido, erectile dysfunction)
A history of fractures, especially from minor injuries
Long-term steroid or opioid use
Smoking or heavy alcohol consumption
Family history of osteoporosis or hip fractures
If any of these apply, you may be at risk of osteoporosis. Alongside specialist investigations, you can also opt to have your testosterone levels checked if you’re experiencing symptoms. Just keep in mind that total testosterone might look “normal,” but your free testosterone (what your body actually uses) or oestrogen levels might still be low.6
Can you regain lost height?
Unfortunately, once the vertebrae have compressed, they don’t spring back.1 But you can stop the loss from getting worse, and sometimes even improve posture and strength with treatment, exercise, and nutrition. Weight-bearing activities, strength training, vitamin D and calcium, and avoiding tobacco and excess alcohol all help keep bones solid.1-6
The numan take
Shrinking with age might seem like a harmless quirk of getting older, but it can be a signal that something’s off beneath the surface. For men, low testosterone may be the hidden factor behind fragile bones, shrinking height, and unexpected fractures.
References
Golds G, Houdek D, Arnason T. Male hypogonadism and osteoporosis: The effects, clinical consequences, and treatment of testosterone deficiency in bone health. International journal of endocrinology. 2017;2017: 4602129.
Matthes KL, Staub K. Height loss in adulthood is associated with health outcomes in later life in men and women enrolled in the 1946 UK Birth Cohort (NSHD). bioRxiv. 2023.
Rinonapoli G, Ruggiero C, Meccariello L, Bisaccia M, Ceccarini P, Caraffa A. Osteoporosis in men: A review of an underestimated bone condition. International journal of molecular sciences. 2021;22(4): 2105.
Kantor SM, Ossa KS, Hoshaw-Woodard SL, Lemeshow S. Height loss and osteoporosis of the hip. Journal of clinical densitometry: the official journal of the International Society for Clinical Densitometry. 2004;7(1): 65–70.
Nassar GN, Leslie SW. Physiology, testosterone. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
Drake MT, Khosla S. Male osteoporosis. Endocrinology and metabolism clinics of North America. 2012;41(3): 629–641.
Anastasopoulou C, Barnett MJ, Rodrigues Silva Sombra L, Garla VV. Osteoporosis in males. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.