During aging, men lose less bone than women because they gain more periosteal bone, not because they resorb less endosteal bone

Abstract

Bone size is greater in young men than in women but the load imposed is also greater. Therefore, the load per unit area (stress) on the vertebral body is the same in men and women. Fractures are uncommon in young adulthood because volumetric bone mineral density (vBMD) is normal so that the stress imposed on the bone is well below its strength in both sexes. The gender difference in bone fragility emerges during aging because the biomechanical relationship between the stress on bone and its strength changes in men and women. Periosteal apposition occurs in both genders during aging but more in men than in women so that vertebral cross-sectional area (CSA) increases more in men than women. Co..