Osteoporosis leads the skeleton to weaken and bones to break and it poses a significant threat to millions of men in the United States. Despite these compelling figures, surveys suggest most American men view osteoporosis as a “woman’s disease.” Furthermore, in men whose lifestyle habits put them at increased risk, not many recognize osteoporosis to be a threat to their mobility and independence.

Osteoporosis is often called a “silent disease” because it progresses without symptoms until a fracture occurs. Men develop osteoporosis less often than women because of their larger skeletons and their bone loss starts later and progresses more slowly. Men also don’t have a period of rapid hormonal change and bone loss.  In today’s healthcare landscape, clinicians must recognize the issue of osteoporosis in men as an important health issue, particularly with the aging of our society and increase in life expectancy.

Osteoporosis can be categorized into two main types: primary and secondary. Primary osteoporosis is due bone loss attributable to aging or it can be idiopathic. Secondary osteoporosis can be due to a myriad of etiologic factors including: steroids, low testosterone, smoking, excess alcohol intake, and systemic diseases such as thyrotoxicosis, gastrointestinal disorders, some neoplasms and rheumatoid arthritis to name a few.  Most men who suffer from osteoporosis have at least one secondary factor and usually due to certain lifestyle behaviors, diseases, or medications.

Women are usually diagnosed in midlife with osteoporosis after undergoing a bone mineral density (BMD) test. However, men often don’t get a diagnosis of osteoporosis till after fracturing a bone or unless he reports back pain to his doctor. Therefore, it is critical that men to inform their doctors about possible risk factors for developing osteoporosis including loss of height or change in posture,  or sudden back pain.

Management plans for osteoporosis include nutritional guidance, exercise and improving lifestyle behaviors. Prevention by means of age appropriate calcium and/or vitamin D supplements and weight bearing and weight resistance exercises are far better than treating broken bones.

men are fragile too

Why is this relevant?

  • Clinicians should recognize that men may be vulnerable to osteoporosis due to lifestyle behaviors, diseases or medication
  • Encouraging age appropriate supplementation, exercise and improved lifestyle behaviors may support better bone health outcomes in men

[1] Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, 2010

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