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Osteoporosis In Men

Osteoporosis in men is an important health concern both in the United States and Canada.

An estimated two million American men suffer from the condition and over 100,000 men fracture a hip each year.

Osteoporosis Canada reports that the number of fractures of the spine is similar in men and women over the age of 50 and elderly men account for almost 30 per cent of hip fracture cases.

Even more importantly, men are more likely to die after a hip fracture than women as the broken bones can lead to significant physical and emotional problems.

The condition is more often to go undiagnosed in men because doctors think of osteoporosis as a women's disease.

On average, men have 25% more bone mass than women both because of their greater size and because testosterone helps to stimulate bone and muscle growth. Like women, they begin to lose bone in their late thirties or early forties but the process is much slower than for women. Instead of losing .5- 1% of their bone each year, men lose only about .3% annually. This gradual bone loss continues as a man enters his fifties in contrast to the sudden drop that women experience after menopause. Women typically begin to have fractures in their fifties while men usually have another decade or two before they have a fracture.

Many bone fractures occur because of a fall. Beginning around age 30, men lose about 1% of their muscle strength each year. This change accelerates to about 2% per year after age 60 and by the time a man reaches 80, he has typically lost about 60% of the strength he had at age 30.

The primary risk factors for men include:

  • Use of Glucocorticoids (such as prednisone and cortisone) for more than three months (Diseases that are often treated with glucocorticoid medications include rheumatoid arthritis, asthma, Crohn’s disease, colitis, and obstructive pulmonary disease.)
  • Age greater than 65

Other key risk factors include:

  • Prolonged use of acid reflux medication
  • Excess alcohol consumption (more than two drinks a day)
  • Primary or secondary hypogonadism (Low levels of male hormones put men of all ages at risk.)
  • Smoking
  • Family history of bone fractures
  • Low Body Mass Index (BMI)

Secondary causes of bone loss include:

  • Primary or secondary hyperparathyroidism
  • Medical conditions that inhibit absorption of nutrients, such as celiac disease or inflammatory bowel disease
  • Rheumatoid arthritis
  • Hyperthyroidism
  • Malignancy (e.g., myeloma or bony metastasis)
  • Hepatic insufficiency (liver functions below normal range)
  • Chronic lung disease
  • Hypercalciuria (elevated calcium level in the blood)
  • Insufficient vitamin D

An inactive lifestyle or a prolonged period of inactivity due to an injury or illness can also raise the risk of bone loss. The US National Osteoporosis Foundation suggests the following measures to prevent unnecessary loss: