Virtually every woman knows about osteoporosis, the cause of weakened bones and fractures as women age. But, men often fail to recognize factors that could increase osteoporosis, a disease that causes the skeleton to weaken (even though men have larger skeletons) and bones to break, (loss starts later in life and progresses more slowly) because the majority of men who face similar risks view osteoporosis as a woman's disease. Because of this way of thinking, osteoporosis is now a significant threat to over two million American men and the numbers are predicted to double by 2050, if the problem of osteoporosis in men is not recognized and treated.

It's common for women in their 70s to lose up to 50% of their total bone mass. Men experience a similar process, but without the rapid bone loss. But even though men lose bone mass more slowly than women it takes them longer to start getting fractures until he reaches his mid-70s, and by then his risk for getting osteoporosis is about the same as a woman's risk.

And even though the body is continually creating and breaking down bone, the creation of new bone for both men and women after age 35 break down, and they lose more bone than they create, leading to an overall loss of bone strength. Hospitals and nursing homes in the United States spend an estimated $14 billion each year in direct costs for osteoporosis and related fractures. (Source - National Institutes of Health, Osteoporosis and Related Bone Diseases.) These numbers could help physicians better understand how to prevent, manage and treat osteoporosis in men.

According to the National Osteoporosis Foundation, more than 2 million men have osteoporosis and 3 million men are at risk for the disease. Each year, men suffer one-third of all hip fractures and one-third of these men will not survive more than one year, generally as a result of an accompanying illness. While 30 percent of men 50 years and older will suffer an osteoporosis-related bone fracture at some time in their lives, only about 20 percent of those men with osteoporosis get diagnosed and are often diagnosed only after they have suffered a fracture, either in the wrists, hips or spine. Today, osteoporosis is responsible for more than 15 million fractures annually, including 300,000 hip fractures, approximately 700,000 vertebral fractures and 250,000 wrist fractures.

Several risk factors have already been linked to osteoporosis in men, and chronic diseases that affect the kidneys, lungs, stomach and intestines or alter hormone levels, including undiagnosed low levels of the sex hormone testosterone and unhealthy lifestyle habits.

1- Low body weight in men over 70 years of age. Recent weight loss of more than 10% due to inadequate physical exercise, use of medication, low calcium intake, smoking and drinking increases the risk. Men weighing 150 pounds or less are 20 times likely to get osteoporosis because they have smaller bones. (Supplements with calcium and vitamin D are essential for bone strength.)

2- Although prostate cancer alone does not increase a man's risk of osteoporosis, some of the treatments do. The Leuprolide (Lupron) drug reduces levels of androgens (male hormones) that play a protective role in bone strength. Men who are given anti-hormone drugs for prostate cancer, or who have undergone actual castration, are now considered to be at high risk for osteoporosis.

3- Men with chronic pulmonary disease develop osteoporosis. Smoking weakens bones and steroid drugs used to control the disease decreases bone strength.

(In February 2008, the National Osteoporosis Foundation issued official guidelines for Treatment and Prevention of osteoporosis in both women and men age 50 and older. See website below.)

The best ways to increase bone mass during peak bone-building years is educating oneself with the treatments and preventions available. Exercise increases balance and muscle strength, which is important for avoiding falls, although any form of exercise is beneficial. However, weight-bearing aerobic workouts such as lifting weights may be superior to swimming or biking. And many of the drugs (Fosamax, Actonel, Miacalcin and Forteo) that treat osteoporosis in women are also effective in men. Each of these drugs slows bone loss and increases the body's ability to build new bone. But, of course, your doctor is the only professional who could advise if you need drugs, and if so, which drug is right for you. As well, some researchers have linked Prozac, Paxil and Zoloft with lower bone density. If it's not possible to remove the patient from the antidepressants, men should ask their doctors to screen them for osteoporosis.

Osteoporosis is called a silent disease because it progresses without symptoms until a fracture occurs. Advanced research is encouraged by doctors, not only to manage and treat men with osteoporosis, but more important to examine men for osteoporosis.

References
www.nof.org (National Osteoporosis Foundation)
www.niams.nih.gove/health_info/bond/default.asp
www.arthritis.about.com/od/osteopor/a/cope/chronicpain_2.htm
(American College of Physicians (Health News - May 8, 2008) reports that "the prevalence of osteoporosis is estimated to be 7% of white men, 5% of black men and 3% of Hispanic men in the United States." However, the group that had conducted the study concluded "those figures are expected to grow as the population ages within the next 15 years.")