About

Osteoporosis is called a “silent disease” because it grows without symptoms until you suffer a fracture. It develops less often in men than in women because men have larger skeletons. Bone loss in males starts later and progresses more slowly than in females.  There is also no period of rapid hormonal change and subsequent bone loss. Recently, the problem of osteoporosis in men has been recognized as an important public health issue, particularly in light of the number of men estimated to live beyond the age of 70 will continue to increase as life expectancy continues to rise.

Our bones are constantly changing as we progress from child to adult, as old bone is replaced by new bone. In their 30s, men have typically accumulated more bone mass than women because their skeletons are larger. Bone mass begins to deteriorate at different rates in men than in women. Excessive bone loss means that older bones are more likely to fracture.

Fractures resulting from osteoporosis commonly occur in the hip, spine and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Because hip fractures tend to occur with older men, men who sustain hip fractures are more likely than women to die from complications.

FYI

Osteoporosis can be classified as primary or secondary. Primary osteoporosis is caused by age-related bone loss. Secondary osteoporosis is caused by certain lifestyle behaviors, diseases or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications (anti-inflammatory compounds), hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria (high levels of calcium in the urine) and lack of exercise.

• One in 4 men over age 50 will break a bone due to osteoporosis.
• Approximately 2 million American men already have osteoporosis. About 12 million more are at risk.
• Each year, about 80,000 men will break a hip.
• Men are more likely than women to die within a year after breaking a hip, due to related complications.
• Men can break bones in the spine or hip, but this usually happens at a later age than women experiences their breakages.

Risk factors for Osteoporosis in Men

• Chronic diseases affecting kidneys, lungs, stomach, and intestines or alter hormone levels
• Regular use of certain medications, such as glucocorticoids
• Undiagnosed low levels of the sex hormone testosterone
• Unhealthy lifestyle habits such as: smoking, excessive alcohol use, low calcium intake and little to no physical activity
• Age. The older you are, the greater your risk of developing bone health issues
• Race. Caucasian men appear to be at particularly high risk, but all men can develop osteoporosis

Causes of Osteoporosis in Men

• Other immunosuppressive drugs
• Hypogonadism (low testosterone levels)
• COPD and asthma
  
• Cystic fibrosis
• Gastrointestinal disease
  
• Hypercalciuria (excessive amounts of calcium lost in urine)
• Immobilization

Symptoms

Osteoporosis does not have symptoms in the early stages of the disease. The only way to tell for sure is when looking at your family history and having bone scans performed at your medical visit.

Symptoms include:

• Back pain
• Loss of height and stooped posture
• A curved upper back
• Broken bones (fractures) that might occur with a minor injury, especially in the hip, spine camera.gif, and wrist
• Compression fractures in the spine potentially causing severe back pain. Often these fractures cause only minor symptoms or no symptoms at all.

Prevention

• Avoid smoking
• Limit alcohol usage
• Increase your level of physical activity
• Take calcium & Vitamin D supplements (if recommended by your provider)
• Exercise. Do weight-bearing exercises that are recommended by your provider after examining you for abilities.
• Discuss with your doctor the use of medications that are known to cause bone loss, such as glucocorticoids.

Recognize and seek treatment for any underlying medical conditions that affect bone health (i.e. low testosterone)

Diagnosis

Osteoporosis can be effectively treated if detected before significant bone loss has occurred. Your health care provider will perform tests to diagnose osteoporosis including a complete medical history, x-rays and urine and blood tests. They may also order a bone mineral density test, which can identify osteoporosis, determine your risk for fractures (broken bones) and measure your response to osteoporosis treatment.

Once your DEXA scan is complete you will get a T-score and a Z-score.

• The T-score – This is a bone density report that shows how much your bone mass varies or deviates from the bone mass of an average healthy 30 year old adult in your gender.
• The Z-score  – This is an average that compares your bone density score to the average bone density of people the same age and gender as you.  This type of score assists in diagnosing secondary osteoporosis and for looking at the bone density of children and young adults who have not yet achieved adult bone mass.

Questions to Ask Your Health Care Provider

• What can I do to stop my osteoporosis from worsening?
• Can the medicines I take for other health problems cause bone loss?
• How can I prevent fractures?
• How frequently should I have a bone density test?
• How much calcium and vitamin D do I need every day, and how can I get enough of these nutrients?
• How much exercise do I need to boost bone strength, and which exercises do you recommend?
• Is hormone replacement therapy safe for preventing osteoporosis?
• What osteoporosis treatments are available that prevents bone loss?
• What are some other lifestyle changes I should make now to keep my bones strong?
• What does my T-score mean?

Treatments

Once you have been diagnosed with osteoporosis, your health care provider may recommend you take calcium and Vitamin D supplements, prescribe medication and also provide you with nutrition, exercise and lifestyle guidelines for preventing further bone loss.

Resources

National institute of Arthritis and Musculoskeletal and Skin Diseases
NIH
National Osteoporosis Foundation