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Did you know that 20 percent of men eventually develop osteoporosis? Or that a man is 50 percent more likely than a woman to die of complications of osteoporosis that result in a broken hip? Here are 10 important facts about men and osteoporosis.

Osteoporosis that leads to broken bones can devastate quality of life. After the age of 50, a man has about a one in five chance of breaking a bone due to osteoporosis.

Just as women can break their hips, men also suffer hip fractures due to osteoporosis. Every year, about 80,000 American men over the age of 65 break a hip. Men account for about one-third of broken hips worldwide, and a man is 50 percent more likely to die of complications of a broken hip than a woman.

Prevention of osteoporosis in men is possible when men are armed with the necessary knowledge. Let’s take a look at 10 things everyone needs to know about osteoporosis in men.

1. Bone fractures caused by osteoporosis in men are usually low-impact events

A man who fractures an osteoporotic bone may not even remember the event that causes the break. Most bone fractures due to osteoporosis are "low-impact". Bending a little too far or picking a little too much or pushing a little too hard causes the bone to break. The fracture may not be debilitating. It’s possible to fracture a hip and still be able to walk, for example. The pain of a fracture may simply go away on its on in four to six weeks. But ignoring the underlying condition increases the risk of a disabling broken bone.

2. Men often don’t recognize the pain of osteoporosis

Bone fractures usually cause dull pain that just won’t go away. They can also cause symptoms that don’t make sense. A bone fracture can make it difficult to swallow or breathe. It’s possible to mistakenly self-diagnose a fracture as an stomach upset. The problem with ignoring a fracture is that once a man has had one low-impact fracture, he is four times more likely than average to have another.

3. Body fat tends to protect against osteoporosis

Osteoporosis is usually a greater risk for thin people than for heavy people. The need to carry a lot of weight around increases the activity of bone-building cells (osteoblasts) as bones remodel themselves to support increased body mass. There is one kind of fat, however, that poses a special benefit to men. Fat cells in the buttocks break down testosterone and make estrogen. This estrogen in turn stimulates the creation of new bone. A big butt may not be esthetically pleasing, but it could protect bone health.

4. Corticosteroids are a special hazard for men

Up to 50 percent of men who are given steroids for pain or inflammation or muscle injury develop a bone fracture as a result. The fracture may not occur for up to a year after steroids are discontinued.

5. Long-term digestive problems can lead to osteoporosis

Anything that reduces the absorption of calcium can cause osteoporosis. These conditions include celiac disease, lactose intolerance, and reflux disease treated with antacids.

6. Treatment for prostate cancer often causes bone loss

Men who have prostate cancer are often given GnRH inhibitors. These drugs stop a cascade of hormone production to lower testosterone production. The problem with reducing testosterone production is that it also reduces the tiny amount of estrogen a man’s body produces. Without this estrogen, the breaking down cycle of bone remodeling is accelerated but the building up cycle is slowed down. This effect is so detrimental to bone health that most men who get these drugs for prostate cancer will need other drugs to protect their bones.

7. 'Weight lifting' can be either very helpful or very harmful for men at risk for osteoporosis

Healthy bones are constantly remodeling themselves to handle stress. In an otherwise healthy man, weightlifting or other forms of resistance exercise stimulate both the breakdown and the recreation of bone. In a man who already has undetected osteoporosis, however, resistance exercise can fracture weakened bones, sometimes with the same level of disability as broken bone during a contact sport.

8. On the other hand, 'weight-bearing' exercise is safe for men at risk for osteoporosis

The kind of weight that is almost always safe for a man to lift is his own body weight. The idea in "weight-bearing" exercises is to use the force of gravity to strengthen muscles without having to pump iron.

Examples of weight-bearing exercises that strengthen bones include:

  • Brisk walking
  • Climbing stairs
  • Dancing
  • Elliptical training machines
  • Bicycling
  • Tennis
  • Stair-step machines
  • Yard work, such as trimming hedges or pushing (not riding) a lawnmower
  • Low-impact aerobics

In the gym, it is usually better to work with elastic bands than with free weights or machines.

9. Hypogonadism causes osteoporosis in men, but testosterone injections can help

Some men suffer from underdevelopment of the testes, testicles, and penis, a condition known as hypogonadism. Underactive male gonads produce inadequate testosterone, so there is not enough testosterone even to produce the tiny amount of estrogen that a man's body needs to maintain healthy bones. Testosterone replacement therapy can treat hypogonadism and strengthen bones. 

10. Lifestyle choices can increase or decrease the risk for osteoporosis in men

Unhealthy lifestyle habits like drinking too much, smoking too much, not getting enough exercise, and not getting enough time outdoors (so that vitamin D deficiency results) increase the risk of brittle bones.

  • Fraser L-A, Adachi JD. Glucocorticoid-induced osteoporosis: treatment update and review. Ther Adv Musculoskelet Dis. 2009, 1:71-85. doi:10.1177/1759720X09343729.
  • Ganji R, Moghbeli M, Sadeghi R, Bayat G, Ganji A. Prevalence of osteoporosis and osteopenia in men and premenopausal women with celiac disease: a systematic review.Nutr J. 2019 Feb 7, 18(1):9. doi: 10.1186/s12937-019-0434-6. Review.
  • Leach MJ, Pratt NL, Roughead EE. Risk of hip fracture in older people using selective serotonin reuptake inhibitors and other psychoactive medicines concurrently: a matched case-control study in Australia. Drugs Real World Outcomes. 2017, 4:87-96.
  • doi.org/10.1007/s40801-017-0107-8
  • Photo courtesy of SteadyHealth.com

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