Osteoporosis Is Not Just A Woman’s Disease

Most people believe that osteoporosis is a condition that predominantly affects postmenopausal women. However, new findings show that many older men are also at risk for osteoporotic fractures, which may carry a greater risk of mortality.

Osteoporosis in Men

Osteoporosis is a condition wherein there is progressive bone loss, in terms of mass and density, which puts one at risk for fractures. The bone is a living matter that undergoes constant formation through deposition, and loss, through the process of resorption. These processes occur as people grow and develop, and continue onto adulthood. Bones weaken when the balance between bone formation and bone resorption is lost, such that bone density decreases, and bones become porous. This increases their risk of being broken or fractured when they are subjected even to mild stress. The bones of the spine (vertebrae), the hips and the wrist are commonly affected.

More often, however, a fracture is the first sign that one experiences before he is aware that he has osteoporosis. More than 1.5 million fractures occur annually in the US, which are related to osteoporosis. Most of these involve the spine, and the rest involve the hip, wrist, and other parts of the body.

Osteoporosis can affect anyone at any age, but elderly women are who are white or of Asian descent are more likely to be involved. However, studies show that more than two million men in the US have osteoporosis and about twelve million more are at risk of developing it. Current worldwide data shows that about one-third of all hip fractures occur in men and that more than one-third of these men die within one year after the fracture.
Weakness or thinning of the bones is often not suspected or diagnosed in men because they have a bigger bone mass than women and bone loss often occurs more slowly. However, new data from the International Osteoporosis Foundation shows that men have higher mortality rates compared to women when it comes to hip fractures. One factor that causes more serious consequences for men is that they are usually older when the fractures occur.

The number of men who have weak bones is predicted to rise dramatically as the number of aging men is increasing.

Causes and Risk Factors

Bone loss usually increases after the age of thirty, and the process of bone formation is not able to keep up with it, resulting in thinning and weakening of bones. In women, the process is hastened after menopause, around the age of fifty, but they are more likely to receive preventive treatments because of the recognized risk.

READ New And Improved Treatment Options For Osteoporosis

Aside from advanced age, other factors that increase men’s risk of developing osteoporosis include:

• Lack of physical activity
• Low testosterone levels
• Low body weight (BMI < 20)
• Chronic diseases, such as liver, thyroid, or kidney disease, inflammatory bowel disease, and rheumatoid arthritis
• Use of certain medications, such as glucocorticosteroids, antacids, anticonvulsants, etc.
• Having a family history of osteoporosis
• Chronic smoking
• Having a previous history of fractures after age 50
• Use of androgen deprivation therapy (for prostate cancer)

Screening And Diagnosis Of Osteoporosis In Men

The best way to test bone strength and solidness is to undergo a bone mineral density test with a DEXA (dual-energy X-ray absorptiometry) scan, which is like an X-ray exam. The National Osteoporosis Foundation recommends testing men over age 70, as well as those aged 50-69 who have risk factors. Men who have noticed a height loss of more than half an inch in one year or 1 ½ inches from their original heights are also advised to take the test. Other indications for screening include men who experience back pain (since they are at risk for vertebral fracture), change in posture, and those who have a history of previous fractures after the age of 50.

How to Prevent Osteoporosis

Exercise. One of the best ways to prevent osteoporosis is to stay physically active. Regular exercise helps keep bones and muscles strong. Experts recommend doing at least 30 minutes (cumulative) of moderate-intensity aerobic exercises daily. These include brisk walking, jogging, dancing, bicycling, and swimming. For additional benefits, one must also do muscle strengthening exercises, which consist of resistance  training, such as weight lifting, pushing, and pulling. Apart from these, staying active also includes doing regular household chores such as gardening, mowing the lawn, and climbing stairs. Elderly people who have medical conditions should consult their doctors before starting a new exercise program.

Calcium Intake. Adults between 18 and 50 years old need 1,000 milligrams (mg) of calcium daily. This amount must be increased to 1,200 mg daily when women reach the age of 50, and men, 70. Calcium-rich foods include:

• Dark green leafy vegetables
• Low-fat dairy products
• Soy products
• Canned sardines/salmon with bones
• Calcium-fortified orange juice and cereals

However, the Institute of Medicine recommends that one’s total calcium intake from food and supplements should not exceed 2,000 mg daily after the age of 50.

Vitamin D Intake. Vitamin D is manufactured in the skin after exposure to sunlight. However, some people who do not get enough sunlight exposure may need to obtain it from food and supplements. It may be found in egg yolks, fortified dairy products, liver, and saltwater fish. Vitamin D supplements may be taken to have a daily intake of 400-800 IU of the vitamin.

Healthy Lifestyle. Reduce your risk of osteoporosis by not smoking, drinking alcohol moderately, and maintaining a healthy weight.

Consult Your Doctor. Other risk factors include chronic medical conditions that predispose to weakening of bones, such as liver, kidney and thyroid disease, intake of certain medications like corticosteroids, low testosterone levels, and prostate cancer treatment. Tell your doctor about these conditions so that proper treatments can be done to reduce your risk of fractures.

READ Osteoporosis Can Strike at Thirty

Treatment of Osteoporosis

Medical treatment for osteoporosis is necessary to prevent pathological fractures which can be life-threatening. This includes medications like:

• Alendronate (Fosamax)
• Risedronate (Actonel)
• Zoledronic acid (Reclast) IV
• Teriparatide (Forteo) SQ
• Testosterone replacement therapy
• Calcitonin injection or nasal spray

The choice of treatment depends on the cause of osteoporosis. Most treatments show immediate improvement within a year and may reduce the likelihood of fractures by half.