Age-Related Osteoporosis Weakens Men's Bones, Too

For years, osteoporosis, or severe thinning of the bones, was thought to be exclusively a woman's disease. We now know that this is not the case; millions of men have osteoporosis, as well.

Osteoporosis typically is viewed as a "woman's disease" because often it is associated with a deficiency of estrogen that occurs following menopause. While accelerated bone loss does occur for a few years after menopause, it ultimately stabilizes, and both sexes experience bone loss at the same rate: 1 percent annually.

In general, from age 60 onward, the average man has the bone density of a woman 10 years younger. So an average man of 60 will have the bone density of the average woman of 50, and by extension, the average woman of 70 will have the bone density of a man of 80. From age 70, osteoporosis becomes more common in men and can cause spontaneous fractures and increased risk of fractures following falls.

There are many factors that lead to an increased risk of osteoporosis. The amount of calcium in the diet throughout childhood, particularly during the teenage growth spurt, determines the strength and length of bone. In your early 20s, your bones contain the most calcium, or the "peak bone mass," and from age 30 onward, bones gradually lose strength. If you do not have adequate amounts of calcium by early adulthood, the risk of osteoporosis later in life is much greater.

Men can experience an increased risk of osteoporosis for a variety of reasons, including vitamin D deficiency (a condition that is epidemic among Americans who live in areas that have four distinct seasons), a sedentary lifestyle, testosterone deficiency and weight loss. Also, there are an array of medications known to increase the risk of bone loss, including treatment with steroids, testosterone-inhibiting medications to treat prostate cancer, and certain medications used to treat diabetes.

In a recent issue of the Annals of Internal Medicine, the American College of Physicians recommends that men who are at high risk of developing osteoporosis be screened for the disease. All men older than 70 are considered at high risk for osteoporosis, but this is particularly serious for men who are underweight; who have lost 10 percent or more of their body weight; who live sedentary lives; or who are taking medication known to cause osteoporosis.

A screening test also should be done in older men who experience any sudden fractures or have been identified incidentally as having bone loss on an X-ray done for some other reason. The most commonly used screening approach is a dual-energy X-ray absorptiometry, also known as a DEXA scan. This noninvasive, simple scan readily diagnoses osteoporosis in men and women of any age.

Prevention is the best treatment of osteoporosis. Sufficient calcium and vitamin D consumption during childhood is vitally important. During growth spurts, teenagers need 1,500 milligrams of calcium daily and at least 800 units of vitamin D. In general, a healthy diet without dairy contains about 500 milligrams of calcium. Four glasses of milk or yogurt or 4 ounces of cheese can supply the body with the additional 1,000 milligrams of calcium. If necessary, a calcium supplement containing vitamin D should be taken.

Once fully grown, men should consume at least 1,000 milligrams of calcium per day. Vigorous exercise, including weight training, also reduces the risk of osteoporosis. From age 70, men should be screened routinely for vitamin D deficiency. If a deficiency is identified, it should be treated immediately.

If osteoporosis is diagnosed, treatment with medications may be necessary. For men, this is typically treatment with biophosphonates (Fosamax, Actonel, Boniva). Fortunately, Fosamax is now available in generic versions, and a three-month supply can be bought for only $10. Without doubt, this inexpensive option should be the first medication of choice. If the generic is not tolerated, then the patient can consider a more expensive alternative.

As men continue to live longer, osteoporosis will become an increasingly serious disease. When symptomatic, it can be very painful and difficult to treat. It contributes significantly to an increased risk of becoming physically dependent, being unable to live alone, and having a poor quality of life. Only through increased awareness, prevention and early treatment can we truly combat this devastating illness. Whether you're a man or a woman, ensuring healthy bones today is the key to a longer, happier and better life.

Source By Dr. David Lipschitz