Men and Osteoporosis

(Berkeley Wellness)
Osteoporosis--Not for Women Only

Osteoporosis, characterized by thinning bones and increased risk of fractures, is not just a woman’s disease. An estimated 2 million American men have it and another 12 million are at elevated risk.

Bone is living tissue that is continually broken down and rebuilt, a process involving calcium, vitamin D, and other nutrients; genes, hormones, physical activity, and other lifestyle habits also play a key role. Both men and women reach peak bone density in early adulthood and begin to lose bone in middle age. But men tend to develop osteoporosis about 10 years later because they generally have bigger, stronger bones to begin with. And it comes on more gradually because they don’t go through menopause, when bone loss accelerates dramatically in women.

Most risk factors for men are the same as for women:

• Older age.
• Family history of fractures.
• Being white or Asian.
• Low body weight or small stature.
• Smoking, heavy drinking, and a sedentary lifestyle.
• Long-term use of steroids, immunosuppressive drugs, anticonvulsants, some antidepressants, and other medications; habitual use of aluminum-containing antacids.
• Certain illnesses, including gastrointestinal, liver, and thyroid disease.
• Dietary deficiencies of calcium, vitamin D, and other bone-building nutrients.
A major risk factor unique to men is low testosterone, especially due to disease or hormone-suppression therapy for prostate cancer.

Warning signs, testing, treatment, prevention

Most men with osteoporosis learn they have it only after they break a hip. You should tell your doctor if you have noticed a loss of height or have sudden back pain, which may indicate a collapsed vertebra. Also talk to your doctor if you have had a previous fracture (especially a “low-trauma” one) or have been on long-term steroids, if osteoporosis runs in your family (especially in males), or if you have multiple risk factors.

A bone mineral density test can detect thinning bones; urine and blood tests may reveal underlying causes of bone loss. There are no official recommendations for bone density testing in older men. Some experts suggest that men 65 and older with a prior fracture and all men 80 and older should be screened; others recommend screening for all men over 65 (same as for women) and younger men with prior fractures.

Some bone loss drugs approved for women are also approved for men, including bisphosphonates. Testosterone therapy may be an option for some men, though it’s not proven to actually decrease fractures and little is known about its long-term side effects. Men with prostate cancer should not take testosterone.

Engaging in regular weight-bearing exercise (such as jogging and weight-lifting), getting adequate calcium and vitamin D, keeping alcohol intake moderate, and not smoking may help slow bone loss and prevent osteoporosis—in both men and women.