Osteoporosis in Men

What is osteoporosis?

Osteoporosis is a disease that thins and weakens bones to the point where they break easily. This disease often affects bones in the hip, spine, and wrist. Though it is most often thought of as a woman's disease, men also get osteoporosis.

How does it occur?

In healthy adults bones continue to grow, reaching their greatest strength around ages 20 to 35. After that, a slow decline in bone strength over many years occurs.

The bones of young boys and teenagers who aren't physically active and don't get enough calcium in their diet are probably not as strong as they would otherwise be. If bones do not become as strong as possible, there is less bone reserve, leaving you more likely to develop osteoporosis as you age. In the US today, only 1 in 4 school-aged boys and male high schoolers gets enough calcium in his diet.

Osteoporosis is most common in white men, but it can occur in men of any race.

Other causes of osteoporosis are:

• a family history of osteoporosis
• long-term use of certain medicines, such as steroids used to treat asthma or arthritis, anticonvulsants, certain cancer treatments, and aluminum-containing antacids
• chronic disease that affects the kidneys, lungs, stomach, and intestines and alters hormone levels (examples of such diseases are diabetes, hyperthyroidism, and congestive heart failure
• lifestyle habits such as
  • smoking
  • having more than 1 drink of alcohol a day
  • too little calcium in the diet
  • not enough weight-bearing exercise such as walking, dancing, or lifting weights
• long periods of bed rest during serious illness
• eating disorders or too much dieting.

What are the symptoms?

There are usually no symptoms until a bone breaks more easily than it ordinarily would. You may break a bone in your spine just by coughing or sneezing, for example. A simple slip and fall may fracture a wrist, hip, or both.

How is it diagnosed?

Osteoporosis, if moderate to severe, can be seen on a regular x-ray. Ultrasound tests may also be used for diagnosis. Bone mineral density can be measured with a special test called a DEXA scan. Blood tests can show if your level of the male sex hormone testosterone is low.

How is it treated?

For both men and women, it is important to get enough calcium and vitamin D, especially if medicine is used to help treat osteoporosis. The recommended daily dose of calcium for men is 1,000 mg per day. Men over 50 should get 1,200 mg daily. Calcium is found naturally in foods such as milk, yogurt, and cheese. It can also be taken as a dietary supplement. The recommended daily dose of vitamin D, which helps your body absorb and use calcium, is 400 to 600 IUs.

Some medicines such as alendronate (Fosamax) and risedronate (Actonel) may be used to prevent and treat osteoporosis. You may be given testosterone if tests show your hormone level is low.

Weight-bearing exercise, such as walking, stair climbing, team sports, and weight lifting, also helps keep your bones strong. Doing this kind of physical activity every day may help stop further weakening of your bones.

How long will the effects last?

The risk of a broken bone resulting from osteoporosis increases with age.

How can I take care of myself?

Follow the treatment advised by your health care provider. In addition, you can:

• Stop smoking. Smokers may absorb less calcium from their diet.
• Limit alcohol intake to no more than 2 ounces of hard liquor, two 12-oz servings of beer, or two 4-oz glasses of wine.
• Get weight-bearing exercise. Walking is especially good. Ask your health care provider if there are any limits on your exercising.
• Eat a healthful diet that includes dairy products and plenty of fruits and vegetables.

You can reduce the risk of injury and broken bones if you:

• Avoid lifting heavy objects.
• Avoid unusually vigorous physical activity; build your activity level gradually.
• Avoid antacids that contain aluminum hydroxide.
• Wear shoes that provide solid support (such as running/walking shoes).
• Use support for walking, such as a cane, if you need it.
• Keep areas where you will be walking well lit and uncluttered.
• Avoid throw rugs on your floors at home.
• Be cautious about going outdoors when roads and sidewalks are icy.

If you are on medicine to treat your osteoporosis, be sure to take it as directed. For example, medicines such as alendronate must usually be taken in the morning on an empty stomach, and you must remain upright for at least a half hour after taking it.

What can be done to prevent osteoporosis?

If you are over age 55, be sure to continue to exercise. Get enough calcium and vitamin D daily, whether from foods you eat or dietary supplements. Get regular weight-bearing exercise, don't smoke, and drink alcohol in moderation.