Osteoporosis in Men: More Common Than You May Think

[CodieCW]

by Krisha McCoy, MS


An estimated 6% of all men over the age of 50 will have an osteoporosis-related hip fracture. This is becoming an increasing concern, since the number of men above the age of 70 is expected to double by the year 2050.

The National Institutes of Health (NIH) is conducting a large, multi-site study to find out more about osteoporosis in men. This study includes more than 5,000 men age 65 and older and will be completed in 2006. Until then, what should men know about osteoporosis?

Osteoporosis
Throughout your lifetime, your bones are constantly changing. Old bone is being removed and new bone is being added. When you are young, your bones grow stronger because you are building bone. Sometime around your late twenties, this changes, and you begin to lose bone faster than it is added.

Osteoporosis occurs when your bones become weak and brittle and therefore break easily. The hip, spine, and wrist are the most common locations of osteoporosis-related fractures. Fractures are a major threat to people’s mobility and independence—and they can be deadly. Almost one-quarter of hip fracture patients over 50 die within one year of the fracture, and men are twice as likely as women to die as a result of complications from a hip fracture.

Everyone is susceptible to osteoporosis, but the following factors increase the risk of developing it:

Being female, especially after menopause
Being over the age of 50
Being Asian or Caucasian
Low bone mass
Personal or family history of fracture over the age of 50
Being thin or having a small body frame
Family history of osteoporosis
Low calcium intake
Use of certain medications, including corticosteroids and anticonvulsants
Low testosterone levels
An inactive lifestyle
Excessive use of alcohol
Cigarette smoking

Osteoporosis in Men
Women are more likely than men to develop osteoporosis for a number of reasons. First, during menopause, women experience a sudden drop in hormone levels, which causes rapid bone loss. Also, men have a bigger bone structure than women. So, even though men still lose bone mass, they have more to begin with. Furthermore, the shift from bone-building to bone loss occurs later in men. On average, boys accumulate 90% of their peak bone mass by age 20, while most girls reach 90% by age 18.

Since women are at higher risk of developing osteoporosis, the media and the health care industry have focused almost exclusively on osteoporosis in women. Many men aren’t even aware they’re at risk.

It is true that men don’t experience rapid bone loss in their fifties like women do. But, by age 65 or 70, men and women are losing bone mass at the same rate. As men get older, their risk of developing osteoporosis increases substantially.

Many cases of osteoporosis in men are due to age-related bone loss, but at least half of the cases are due to some secondary cause. The most common secondary causes of osteoporosis in men are:

Glucocorticoid medication (steroid medications used to treat diseases such as asthma and rheumatoid arthritis)
Hypogonadism (low levels of testosterone, which can occur naturally or be caused by medications, cancer treatments, or many other factors)
Alcohol abuse
Smoking
Gastrointestinal disease (disease of the stomach and intestines that impairs the absorption of bone-building nutrients)
Hypercalciuria (too much calcium lost in the urine)
Immobilization (prolonged bed rest)

How You Can Protect Your Bones
To help preserve your bone health, the NIH recommends the following strategies:

Avoid smoking
Reduce alcohol intake
Lift weights. Resistance training (exercises with weights) have been shown to increase bone mass and strength.
Get sufficient calcium and vitamin D (Recommended daily amounts for men between the ages of 19-70 are 1,000-1,200 mg of calcium and 200-400 IU of vitamin D)
Engage in weight-bearing exercises (ie, walking, jogging, racquet sports, stair climbing, weight lifting)
Discuss medications that might affect bone loss with your doctor.

One of the most important things you can do to protect your bones is detect osteoporosis before a fracture occurs. Since most physicians don’t commonly screen men for osteoporosis, you should alert your doctor if you are at increased risk for developing osteoporosis. Also, discuss the option of osteoporosis screening with your doctor if you have experienced loss in height, change in posture, fracture, or sudden back pain.

To diagnose osteoporosis, your doctor will get your complete medical history, take x-rays, and perform urine and blood tests. You may also get a bone mass measurement, which can detect low bone density, predict your risk for fractures, diagnose osteoporosis, and monitor the effectiveness of treatments.

If you are diagnosed with osteoporosis, it is important that it be treated. Your doctor may prescribe a prescription medication that has been approved to treat osteoporosis in men. You will probably also be placed on a nutrition, exercise, and lifestyle regimen for preventing future bone loss.

RESOURCES:

National Osteoporosis Foundation
http://www.nof.org/index.html

Osteoporosis and Related Bone Diseases-National Resource Center
http://www.osteo.org/

References:

Disease statistics. National Osteoporosis Foundation website.
Available at: http://www.nof.org/osteoporosis/stats.htm.
Accessed October 23, 2003.

Fast facts on osteoporosis. Osteoporosis and Related Bone Diseases-National Resource Center website.
Available at: http://www.osteo.org/newfile.
Accessed October 23, 2003.

Kids and their bones: a guide for parents. National Institute of Arthritis and Musculoskeletal and Skin Diseases website.
Available at: http://www.niams.nih.gov/hi/topics/o...s/kidbones.htm.
Accessed October 23, 2003.

Osteoporosis in men. Osteoporosis and Related Bone Diseases-National Resource Center website. Available at: http://www.osteo.org/newfile.
Accessed October 23, 2003.



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Last reviewed July 2005 by Lawrence Frsich, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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