What Puts Men at Risk for Osteoporosis?

Nearly all media advertisements promoting various medications and supplements for preventing and/or treating osteoporosis focus on women. It is as if men were not vulnerable to developing this bone loss disorder. Although it develops less often, and later, in men than in women (because men have larger skeletons than women and they have no period of rapid hormonal change), osteoporosis has recently begun to be “recognized as an important public health issue, particularly in light of estimates that the number of men above the age of 70 will continue to increase as life expectancy continues to rise” (http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/men.asp).

Facts and statistics from the National Osteoporosis Foundation:

• “Up to one in four men over age 50 will break a bone due to osteoporosis.
• Approximately two million American men already have osteoporosis. About 12 million more are at risk.
• Men older than 50 are more likely to break a bone due to osteoporosis than they are to get prostate cancer.
• 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. This is due to problems related to the break.
• Men can break bones in the spine or break a hip, but this usually happens at a later age than women.” (https://www.bonehealthandosteoporosis.org)

Risk Factors for Men? Several risk factors have been linked to osteoporosis in men:

• Chronic diseases affecting the kidneys, lungs, stomach, and intestines or those that alter hormone levels;
• Regular use of medications such as glucocorticoids;
• Undiagnosed low levels of the sex hormone testosterone (hypogonadism);
• Unhealthy lifestyle habits (e.g., smoking, excessive alcohol use, low calcium intake, and inadequate physical exercise);
• Age. As one ages, the greater the risk;
• Race. Caucasian men appear to be at particularly high risk, but all men can develop osteoporosis;
• Autoimmune diseases such as rheumatoid arthritis. (source: http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/men.asp)

Primary and Secondary Osteoporosis: “There are two main types of osteoporosis: primary and secondary. In cases of primary osteoporosis, either the condition is caused by age-related bone loss (sometimes called senile osteoporosis) or the cause is unknown (idiopathic osteoporosis). The term idiopathic osteoporosis is used only for men younger than 70 years old; in older men, age-related bone loss is assumed to be the cause” (NIH Osteoporosis and Related Bone Diseases National Resource Center). “The majority of men with osteoporosis have at least one (sometimes more than one) secondary cause. In cases of secondary osteoporosis, the loss of bone mass is caused by certain lifestyle behaviors, diseases, or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications, hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria, and immobilization.”(http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/men.asp).

“Glucocorticoids are steroid medications used to treat diseases such as asthma and rheumatoid arthritis. Bone loss is a very common side effect of these medications. The bone loss these medications cause may be due to their direct effect on bone, muscle weakness or immobility, reduced intestinal absorption of calcium, a decrease in testosterone levels, or, most likely, a combination of these factors” (NIH). Recent research suggests estrogen deficiency may be a cause in men but further investigation is occurring. Information at the NIH web site includes explanation of hypogonadism, methods of diagnosis, available treatments, and prevention of bone loss. Currently being researched is whether the BMD test (a dual-energy x-ray absorptiometry) used for women is appropriate for men.

Note: One of the most important preventive action both men and women can do is to engage in regular weight-bearing exercises (yes, this means lifting weights and such activities as walking, jogging, racquet sports, climbing stairs, team sports, weight training, and using resistance machines).

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