Osteoporosis Isn't Just for Women

Osteoporosis affects women four times more often than men. Still, there are two million men in the United States with this disease. And this figure is expected to increase as men live longer. This article reviews osteoporosis in men.

New research shows that estrogen is needed by both men and women to keep bone mass. Without good bone density, adults are at risk for fractures, especially hip fractures. In this report, doctors discuss the role of hormones, genetics, and treatment for osteoporosis in men compared to women.

Scientists aren't sure yet exactly how hormones work in men. It's not clear what goes wrong. Maybe there is an imbalance of hormones. This can cause an increase in bone loss after the bone is formed. Or perhaps not having the right hormones keeps the bone from forming in the first place.

Genetics also plays a role in male osteoporosis. Men with osteoporosis are likely to have other male relatives with this disease.

Treatment begins with prevention. Bone density must be built in young boys through calcium intake and physical activity. Men at risk for osteoporosis must be identified. Risk factors for osteoporosis such as smoking, inactivity, and poor diet can be changed. Alcoholism, low calcium, and low vitamin D are also risk factors for low bone mineral density. Vitamin D comes from sunshine.

Drug treatment is another option for men with osteoporosis. One option is a drug called Alendronate. It used to prevent bone loss once the bone is already formed. Low doses of parathyroid hormone (PTH) can be given off and on. PTH is a bone-forming drug. Fluoride may be useful to boost bone growth, too. Researchers are studying this closely.

The authors conclude that osteoporosis occurs in men slowly over time. Bone loss is highest in men with low levels of hormones such as testosterone and estrogen. Clear guidelines for screening men for osteoporosis aren't ready yet. This report suggests that screening should begin with men who have already had bone fractures. Screening should also be done for men over 75 and men who are alcoholics.



References: Harlan Stock, MD, et al. Osteoporosis: A Disease in Men. In Clinical Orthopaedics and Related Research. August 2004. Vol. 425. Pp. 143-151.