Osteoporosis in Men

Do men get osteoporosis?

Yes. About 20% of osteoporosis is in men. Over 2 million men in the USA have osteoporosis, and another 12 million have low bone density that can lead to fractures. It can occur at any age, but typically is seen in men over age 70.

How do I know if I have osteoporosis?

A simple bone density test can determine whether you have osteoporosis. The International Society for Clinical Densitometry recommends that all men age 70 and older have a bone density test to see if they are at risk for fracture. Osteoporosis can also be diagnosed in the presence of a fracture occurring after little or no trauma, but it is far preferable to make the diagnosis and start treatment before the first fracture occurs.

What causes osteoporosis in men?

Aging is associated with bone loss. Men tend to develop osteoporosis about 10-15 years later in life than women. Many men who have osteoporosis have a cause that can be identified and treated. Common causes in men are low testosterone levels, alcoholism, and chronic glucocorticoid use (prednisone). Men with prostate cancer who are treated with anti-androgen medications can develop osteoporosis. Other risk factors for men include cigarette smoking, low body weight, lack of exercise, and deficiency of calcium and vitamin D. Once a diagnosis of osteoporosis is made, tests should be done to look for an underlying cause and contributing factors. This usually involves some simple blood tests and often a 24-hour urine collection.

What are the consequences of osteoporosis?

Osteoporosis is a silent disease that weakens the bones. There are no symptoms until a fracture occurs- often with minor trauma or no trauma at all. One in four men over the age of 50 will have an osteoporotic fracture in his remaining lifetime. The most common type of fracture is in the spine, which can cause back pain, loss of height, stooped posture, and loss of lung function. Hip fractures usually require hospitalization and surgery, and may result in permanent disability and loss of independence. Men with hip fractures have a death rate that is almost twice as high as women.

How is it treated?

All men should take care to have an adequate daily intake of calcium and vitamin D, and exercise regularly. Avoidance of cigarette smoking and excess alcohol can help. Any disease or contributing factor that is identified in the medical evaluation should be treated. Finally, medications can be given that are effective at increasing bone density, improving bone strength, and reducing the future risk of osteoporotic fractures.