Male Osteoporosis: Are You at Risk?

Osteoporosis typically brings to mind menopausal women over 50. But a surprising number of men also suffer from this bone-thinning disease.

In fact, one in two women and one in four men over age 50 will break a bone due to osteoporosis, according to the National Osteoporosis Foundation (NOF).
 
According to the NOF, men over 50 have a greater chance of breaking a bone due to osteoporosis than they are to get prostate cancer, although it's more apt to occur at a later age. Men are also more likely than women to die within a year of breaking a hip.
 
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As the population ages, even more men will experience the disease. Here's the rundown on the risk factors and ways men can boost their bone density:
 
Osteoporosis Risk Factors for Men
 
Men and women share some similar risk factors for osteoporosis. For example, a family history of the disease increases risk. Unhealthy lifestyle habits, such as smoking and excess alcohol intake, also increase chances you'll develop osteoporosis.
 
On the plus side, men have some advantages over women. "Men have a higher peak bone mass than women," says Dr. Chad Deal, head of the Center for Osteoporosis and Metabolic Bone Disease at Cleveland Clinic. This greater bone mass gives men more time before bone loss becomes a problem, versus women who start with less bone.
 
"Plus, men don't experience the same rapid bone loss women experience at menopause," says Deal. "Men experience a drop in testosterone with age, but it's a slower process."
 
Bone loss for men may begin as early as 45 to 50, but picks up dramatically after 70, at which point men and women lose bone mass at the same rate.
 
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"Men are also more likely to have hypercalciuria or excessive calcium excretion," says Deal. Men with hypercalciuria tend to form kidney stones. They also have an average bone density 5 to 15 percent lower than stone-forming men without hypercalciuria.  
 
Outcomes after a bone break also differ between the sexes. "The disease is more severe when it does occur in men," says Deal. "When a man breaks a hip, he's twice as likely to die than a woman and is less likely to return to pre-fracture functioning."
 
Bone-Thinning Inducers
 
Medications such as long-term steroids (e.g. cortisone and prednisone), used for arthritis and gastrointestinal illness, increase bone-thinning risk as well. Taking steroid medicines in a dose of 5 mg or more for three or more months can increase the chance of developing osteoporosis for men and women, according to NOF.  
 
"Androgen deprivation therapy for prostate cancer that reduces testosterone levels puts men at risk," says Deal, who recommends a bone mineral test for any man who's been on androgen deprivation therapy. Other medications known to cause bone loss include aluminum-containing antacids, some antiseizure medicines, chemotherapeutic drugs, lithium, methotrexate and others.
 
A low body mass index (BMI) in men increases bone loss risk, says Dr. George Hennawi, director of geriatrics at MedStar Good Samaritan Hospital in Baltimore, Md. "A BMI of 19 or lower is concerning," says Hennawi. "As we age ,muscle mass decreases while fat mass increases, so low BMI could indicate low muscle mass due to lack of activity or illness. Bone does not strengthen itself well at such a low weight."
 
Excess alcohol (generally 10 or more servings a week) and smoking also increase the risk of osteoporosis, says Hennawi. Bone loss and rates of hip and spinal fractures are higher among men who smoke, although the exact reason is not known.
 
A loss of height or breaking a bone from a small trauma that does not involve falling, such as while running, may also indicate osteoporosis.
 
Ways to Reduce Your Risk
 
No current recommendations exist for screening men for osteoporosis. "It's not necessary for a healthy 50- to 60-year-old man," says Hennawi. "However, if you have any risk factors you should be screened."
 
Preventative steps you can take include:

• Don’t smoke
• Limit alcohol to two drinks per day (one for women) or abstain completely
• Exercise, using moves that include heel strikes, such as running or walking
• Ensure daily calcium intake of 1,000 mg for men age 51 to 70 (1,200 mg for women)
• Make sure vitamin D intake is 600 IU per day up to age 70; men over age 70 should increase intake to 800 IU
• Include bone-building foods such as yogurt, low-fat dairy, canned sardines and salmon, collard and other dark greens, broccoli, tomatoes (for potassium), bananas, prunes, other fresh fruits and vegetables as well as vitamin D and calcium-fortified foods
• Discuss medications with your doctor, if needed
• Talk to your doctor if you are currently on medications known to cause bone loss
• Treat any underlying medical condition that affects bone health

For more information go to:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases
• National Osteoporosis Foundation

Next Avenue contributor Linda Melone is a California-based freelance writer specializing in health, fitness and wellness for women over 50.