Men: Don’t Let Osteoporosis Weaken Your Bones

It’s common knowledge that osteoporosis, a disease that causes the skeleton to weaken and bones to break, affects women. The National Osteoporosis Foundation estimates there are 2.8 million men with osteoporosis and 14.4 million men with low bone mass (osteopenia).

After age 50, 6% of all men will suffer a hip fracture as a result of osteoporosis. And because of osteoporosis, men also are vulnerable to minor spinal fractures that result in chronic pain in the back and neck.

Not just a woman’s disease

Osteoporosis is not just a “woman’s disease,” says Abby Abelson, MD, Chair of Cleveland Clinic’s Department of Rheumatic and Immunologic Disease.

However, there are important differences between men and women when it comes to osteoporosis, Dr. Abelson says. For men, bone loss starts later and progresses more slowly.

While men in their 50s do not go through the rapid loss of bone mass that women have in the years following menopause, the rates of bone loss are the same by age 65 or 70, Dr. Abelson says.

“There are a number of medical problems that could be associated with bone loss in men,” says family medicine specialist Donald Ford, MD, MBA. “If someone used to be 6’4” and has lost more than 1.5 inches in height, an X-ray is recommended since osteoporotic fractures can cause that loss.”

Additionally, a bone density is recommended for men over age 70 and if, risk factors for low bone mass are present, after age 50.

Once bone is lost, the body can’t replace it with just calcium and vitamin D. Excessive bone loss causes bones to become fragile and more likely to fracture. Osteoporosis-related fractures most commonly occur in the hip, spine and wrists and can be permanently disabling, Dr. Abelson says.

Men who sustain hip fractures are more likely to die from complications than women. More than half of all men who suffer a hip fracture are discharged to a nursing home, and 79% of those who survive for one year after a hip fracture still live in nursing homes or intermediate care facilities.

Osteoporosis risk factors for men

Dr. Abelson says osteoporosis in men is often associated with:

• Prolonged exposure to medications that impact bone density. These include steroids, anticonvulsants, cancer therapies and aluminum-containing antacids.
• Chronic illnesses can decrease bone density. These include kidney problems, lung conditions, hyperthyroidism, parathyroid disease, malabsorptions and other digestive problems.
• Vitamin D deficiency.

Risk factors that affect men and women equally include a family history of osteoporosis, smoking, excessive drinking, low calcium intake and a sedentary lifestyle, Dr. Abelson says.

Triggers for osteoporosis in men

These diseases can trigger osteoporosis in men, Dr. Abelson says:

• Intestinal disorders — Poor absorption of bone-boosting nutrients can result in osteoporosis. Bone loss also can come from steroids used to treat ulcerative colitis and Crohn’s disease. Taking calcium and vitamin D supplements plus osteoporosis medication can offset the problem.
• Prostate cancer — Treatment with the androgen-reducing drug leuprolide can predispose men to low bone mass and fractures. Monitoring bone density is recommended during prostate cancer treatment.
• Hypogonadism —Low testosterone production can affect bone strength. Though sometimes hard to detect, male hormone replacement therapy can correct it.
• Hyperparathyroidism —Overactivity of the parathyroid glands. These secrete a hormone that maintains proper calcium levels in the blood and bones. A growth on the parathyroid gland can cause the condition, which is treated with surgery.

Dr. Abelson says it’s important for men to avoid letting misconceptions prevent them from taking care of your bone health.

“Men get osteoporosis, and when men sustain the fractures from this disease, they may suffer more from the devastating consequences,” she says. “Be aware of bone health even if you’re male — and take preventive steps when needed.”

How to get more calcium in your diet

Getting calcium in your diet is also a good preventative measure, adds Dr. Ford. The recommended daily intake of calcium is between 1,200 and 1,500 mg per day.

“If you don’t eat dairy products, there are actually better sources of calcium that are nondairy,” he says. “Leafy green vegetables and many other vegetables are actually much better sources of calcium than dairy products.”