Osteoporosis in Men

As if there wasn't enough for men to worry about: Osteoporosis, the bone-thinning condition once considered a disease affecting just women, is now coming to light as an under-diagnosed condition in men. In fact, according to the National Osteoporosis Foundation, 2 million American men have osteoporosis and another 12 million are at risk for it. Men over 50 are actually at a greater risk for an osteoporosis-related fracture than they are for prostate cancer.

Osteoporosis has been largely overlooked in men for a few reasons. Men generally have larger and stronger bones than women by the time they are 30, when peak bone density is achieved. Also, men do not experience rapid bone thinning like women do following menopause. But, as in women, the bones of men start to gradually thin and lose strength after age 30. And bone density is affected by heredity, diet, sex hormones, lifestyle choices, physical activity, and the use of certain medications. So although men have a leg up on women in terms of peak bone density, they can still get into trouble if the conditions are right.

The risk factors for osteoporosis in men include:

• a parent who suffered from osteoporosis
• smoking, excessive alcohol use, low calcium intake, and inadequate physical activity
• prolonged use of steroids, such as prednisone or cortisone, to treat asthma or arthritis, anticonvulsants, certain cancer treatments, or aluminum-containing antacids
• chronic diseases affecting the kidneys (including kidney stones), lungs, stomach, intestines, and altering hormone levels
• low levels of testosterone.

Men who have one or more of these risk factors should talk with their doctor about their bone health. In addition, men who have sudden back pain, a loss in height, or change in posture should also talk with their doctors about the condition.

To help prevent osteoporosis, men (and women) can change unhealthy habits such as smoking and drinking, partake in weight-bearing exercises, treat any underlying medical conditions that affect bone loss, and ensure an adequate daily intake of calcium (1,200 mg per day after age 50) and vitamin D (400 IU or at least 10 minutes of sunlight daily).

While the treatment of osteoporosis in men is not well researched, a few options are available. Only alendronate (Fosamax) has been approved for osteoporosis in men. However, it is perfectly legal and proper for doctors to use their judgment to prescribe men medications that have been approved only for women. These include risedronate (Actonel) and calcitonin (Miacalcin, Calcimar). While estrogen and estrogen-like medications are used to treat osteoporosis in women, they are not used in men. As more information becomes known about how men develop osteoporosis, further treatment options should become available.

December 2003 Update

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