Men and Osteoporosis: Red Flags That Are Often Overlooked


A man over the age of 50 has a greater chance of suffering a fracture as a result of osteoporosis than of being diagnosed with prostate cancer. And almost one in five men will suffer a hip fracture by age 90, with a third of them dying as a result of complications during healing.

But osteoporosis continues to be viewed solely as a disease of women--even among doctors. "It's a disconcerting problem," comments Lei Wang, MD, a physician at the Tufts-affiliated New England Medical Center. "As doctors, we often don't talk to male patients about their bones. Even when male patients present symptoms of osteoporosis identical to those of female patients-such as back pain-we may neglect osteoporosis as a potential culprit." It's not surprising when you consider that no uniform recommendation exists for the routine screening of men for osteoporosis, as it does for women.

For that reason, it's important for men to be aware of red flags for the disease, such as loss of height, changes in posture, and sudden back pain. There are a number of conditions that can raise osteoporosis risk, including use of drugs like corticosteroids, anticonvulsants, and chemotherapeutic agents; low testosterone levels; intestinal, liver, or kidney disorders that could affect use of calcium and vitamin D; alcoholism; and limited mobility.

Fortunately, treatment options for men with osteoporosis continue to expand. While the estrogens used in women's hormone replacement therapy and the hormone-like drug raloxifene (Evista) are not considered appropriate options, the Food and Drug Administration has given approval for men to take alendronate (Fosamax) and, in cases of steroid-induced osteoporosis, risedronate (Actonel). In addition, physicians may also prescribe testosterone replacement therapy and calcitonin (Miacalcin). The latter is only officially approved for women at the moment but may work similarly to reduce bone loss and prevent fractures in men.

Of course, men, like women, should do all they can to prevent osteoporosis in the first place: avoid smoking and excessive alcohol intake; consume at least 1,000 milligrams of calcium and 400 International Units of vitamin D each day (1,200milligrams of calcium if you're 51 or older and 600 units of vitamin D if you're at least 71); and engage regularly in weight-bearing exercise, such as brisk walking or jogging.

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