Gentlemen, when someone mentions osteoporosis, do you picture an older woman falling and fracturing her hip? If so, it’s time to, uh, bone up on the subject.
While the disease is more common in women, men are also at risk for osteoporosis. The misconception that osteoporosis is a “women’s disease” likely stems from the fact that women are at risk a little earlier in life, typically beginning in their 50s, right around menopause. Yet men over age 70 are equally at risk. And now that many more men are living into their 70s and beyond, osteoporosis is a growing men’s health issue.
Photo courtesy of University College London.
Osteoporosis — a weakening of the bones — is mostly age-related. As we age, new bone formation slows, making bones more fragile. Women are at higher risk for osteoporosis at a younger age partly because their skeletons tend to be smaller than men. In addition, loss of estrogen at menopause helps accelerate bone loss. But by about age 65, men and women are losing bone mass at the same rate.
The biggest cause for worry is this: roughly one in four men over age 50 will break a bone due to osteoporosis. Yet women are far more likely to get tested for bone density and start taking calcium and vitamin D supplements after breaking a bone.
“Men who have experienced a fracture over the age of 50 need to be proactive,” said Deborah Kado, MD, associate professor and bone health specialist at UC San Diego Health. “Instead of just chalking it up to being a freak event, that fracture should be a wakeup call to see a doctor and get a bone density scan. At that point, men might want to also think about becoming more physically active and improving their balance.”
What does the latest research say?
Just because older men and women are equally at risk for osteoporosis and bone fractures doesn’t necessarily mean it’s for the same reasons. To take a closer look at risk factors for osteoporosis and bone fractures in men over 65, Kado and UC San Diego School of Medicine colleague Elizabeth Barrett-Connor, MD, are leading a nationwide study funded by the National Institutes of Health. The research team is interested in learning how fracture risk in men aged 65 years and older is related to bone mass, lifestyle choices and other factors.
Since the study began in 2000, these men return every few years for in-depth clinic visits to evaluate their bone density and muscle strength, complete detailed questionnaires regarding their health and habits and undergo many other tests. In addition, every four months, the men are in contact via postcard regarding any falls or fractures they have sustained. More than 14 years later, almost 600 men from the San Diego area continue to participate in this study.
A number of previously unappreciated hip fracture risk factors have recently emerged from this study. Apart from older age (over 75), the researchers found that a previous fracture after the age of 50, greater height, use of tricyclic antidepressants, a previous heart attack, hyperthyroidism and Parkinson’s disease are all associated with an increased risk of hip fractures in older men.
On the flip side, men in this study who had a good-paced gait and were able to stand up and sit down from a chair without difficulty multiple times in a row were less likely to experience a hip fracture. The same was true for cognitively sharp men in the study.
While older men and women do share some common hip fracture risk factors, such as increased age and low bone mineral density, some of the hip fracture risk factors previously reported in women, such as parental history of fracture and fast heart rate, were not found in men.
What’s your risk for osteoporosis? Check your osteoporosis risk.
How can men (and women) prevent osteoporosis and bone fractures?
- Quit smoking
- Get at least 30 minutes of weight-bearing exercise each day
- Limit alcohol consumption
- Consume sufficient amounts of calcium and vitamin D through a healthy diet and supplementation, if needed
- Talk to your doctor if you have already experienced a bone fracture after age 50 or if you are taking glucocorticoid medications, as bone loss is a common side effect