Opinion Osteoporosis Afflicts Men, Too, Not Just Women

Most people don’t think that men develop osteoporosis. This disease, in which bone becomes thin and fragile and can fracture easily, is mostly associated with women.

Doctors don’t often discuss the issue with their male patients. But men can get the hip and other bone fractures that come with osteoporosis, too, and it’s no less painful or debilitating for them than it is for women.

Men are usually diagnosed with osteoporosis only when they have fractured a bone. Men don’t generally experience the rapid bone loss in their 50s that women do, but by age 65 or 70, they are losing bone mass at the same rate as women. Hip fractures occur at older ages in men, which might explain why men who break a hip are more likely to die of complications than women. More than half of all men who suffer a hip fracture go from the hospital to a nursing home, and 79{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of those who survive for one year still live in nursing homes or intermediate care facilities.

Scientists are currently trying to learn more about the causes, diagnosis, treatment, and prevention of osteoporosis and its related fractures in men as well as in women.

To that end, in 1999, the National Institute of Arthritis and Musculoskeletal and Skin Diseases and two other National Institutes of Health (NIH) components, the National Institute on Aging and the National Cancer Institute (NCI), launched a seven-year study that is following 5,700 men age 65 or older. “Mr. OS,” as it is called, aims to determine the extent to which the risk of fractures in men is related to bone mass and other factors such as their bone structure, lifestyle, and tendency to fall.

In the NCI component of “Mr. OS,” scientists are trying to answer the question of whether having a high bone mass is associated with an increased risk of prostate cancer. Women who have a high bone mass have a higher risk of getting breast cancer. Both types of cancers are thought to be associated with a lifetime of exposure to the sex hormones the body makes.

NIH’s National Heart, Lung, and Blood Institute (NHLBI) is also supporting a part of “Mr. OS” that is looking at the role of sleep in the health of older men.
Men are more likely than women to have a high risk of fracture due to secondary causes, like a specific disease (such as celiac disease, in which a person’s intolerance to a protein found in wheat and other grains interferes with their intestinal absorption of calcium) or taking medications that can affect bone mass (like the steroids used to treat asthma, rheumatoid arthritis, and other diseases). Knowledge of the diseases and conditions that can affect bone mass can help to prevent men as well as women from reaching the point of fracture before diagnosis.

Getting enough calcium is very important for preventing osteoporosis. Adults 19 to 50 years old need 1,000 mg of calcium every day; those over 50 need 1,200 mg. The best way to get enough calcium is through diet, with such foods as fortified orange juice and cereals; green, leafy vegetables; and low-fat dairy products such as cheese, milk, ice cream, and yogurt.

Individuals should also get enough vitamin D. By spending 15 minutes outside in the sun each day, the body should make enough on its own.

It’s also important to do regular weight-bearing exercise, such as walking, jogging, stair-climbing, tennis, weight training, or dancing. These exercises may strengthen bones and may also help with balance. That will reduce the risk of falling and thus reduce the chances of breaking a bone.

For men who already have osteoporosis, doctors are prescribing most of the same medications that they are giving to women. Alendronate (brand name Fosamax) and risedronate (brand name Actonel) both now come in a once-a-week pill. But they can cause problems with the stomach or esophagus if not taken exactly as directed. The U.S. Food and Drug Administration has approved teriparatide (brand name Forteo) only for those who are at high risk of fracture; the drug must be injected daily for no longer than two years.

Bobbi Bennett writes for Word on Health, an online publication of the National Institutes of Health. For more information about osteoporosis, go to www.osteo.org.