Osteoporosis is not just a woman’s problem

It's not well-known, but osteoporosis, the bone-thinning disease that causes fractures in older people, affects men as well as women. And physicians think that not enough men are being screened for the disease.

Everyone's bones get thinner as they age. Our bodies break down old bone and replace it with newer bone cells. As we get older, the rate at which our bodies make new bone cells slows. So more bone gets broken down and less is made.

This happens faster in women around the time of menopause because of hormonal changes. And women often start off with thinner, lighter bones than men anyway. So, older women are most likely to get broken bones because of osteoporosis.

But we are all living longer now and more men are getting osteoporosis: the disease now affects 7% of white men, 5% of African-American men and 3% of Hispanic men. New guidelines from the American College of Physicians say that the disease is often underdiagnosed and undertreated in men. They also encourage men over the age of 65 to be regularly checked by their physicians to see if they are at risk.

Men's risk of osteoporosis could be increased by:

• Being older than age 70
• Having a low body weight
• Weight loss (compared to previous adult weight)
• Doing little or no physical activity
• Having had a fracture not caused by a major fall or accident
• Long-term use of certain medications, including corticosteroids and some drugs given for prostate cancer.

Men who are at risk should have a bone scan, called a DEXA scan. If the scan shows weak bones, they should consider taking medications to strengthen their bones. Broken bones, especially hips, are a major cause of disability for older people, both men and women.

What you need to know

If you're male and older than 65, talk to your doctor about osteoporosis. Ask about a bone scan.

—Anna Sayburn, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.

Comments

[Roy Smithson]

I'm a male and just turned 70 this month. In June-1997, as part of an ultra-thorough physical exam, a DEXA scan was done (after one look at me, doctor decided to omit it, but I requested it anyway). As a result Osteoporosis was discovered in me (70% of normal density), though my wife with early menopause (hyst) was fine--and still is today.

Finding this was a shock to doctors and us because, at the time, I was a husky 59-year-old (5'11", 270 lbs), in apparently pretty good health, and never seriously sick in my life. Though extensive tests were run, no cause was ever identified.

Since then, I've been able to improve the density steadily until it's now Ostopenia--this despite 11 years of potential additional loss due to increasing age. I'm yet to take a bisphosphonate though. So far, no fractures.

So, I would strongly recommend that EVERYONE have a DEXA scan well before 70 to make sure their bones are OK, and to establish a baseline. They should get a full copy of the color printout the DEXA computer produces and the radiologist's report--AND personally study it and file it. The DEXA only costs $250-$300, takes about 30 pleasant minutes, and involves minimal radiation exposure. It's worth that even if one has to pay out of their own pocket, as I did.

There are loads of things one can do (without drugs) to improve their density, but those are easier and more effective the younger on is. Starting early is extremely important and time is critical. Building bone density doesn't happen overnight; it takes time!

RES