| Despite the lower frequency of male primary osteoporosis compared to women, men exhibit elevated rates of disability and mortality subsequent to osteoporotic fractures. In recent years, there has been a growing focus on the risk factors linked to male primary osteoporosis. This review summarizes current evidence regarding the roles of aging, estrogen levels, systemic inflammatory markers, testosterone and other androgens, sex hormone-binding globulin (SHBG), primary sarcopenia, and genetic factors in the development of male primary osteoporosis. Available data indicate that these factors play pivotal roles in the pathogenesis of male primary osteoporosis. However, most studies remain limited to single-factor analyses, with insufficient exploration of underlying mechanisms and interactions among multiple risk factors. Future research should prioritize multidimensional analyses, mechanistic investigations, and clinical validation to clarify the clinical relevance of these factors, thereby providing a theoretical foundation for early screening and individualized intervention in male osteoporosis. |