Most people don't think that men develop osteoporosis. This disease, which makes bones thin and fragile and can fracture easily, is mostly associated with women. Doctors don't often discuss the issue with their male patients. But men can get the hip and other bone fractures that come with osteoporosis, too, and it's no less painful or debilitating for them than it is for women.
It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss. But by age 65 or 70, they are losing bone mass at the same rate as women.
Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Hip fractures occur at older ages in men, which might explain why men who break a hip are more likely to die of complications than women. More than half of all men who suffer a hip fracture go from the hospital to a nursing home, and 79 percent of those who survive for one year still live in nursing homes or intermediate care facilities.
Primary and Secondary Osteoporosis
There are two main types of osteoporosis: primary and secondary. In cases of primary osteoporosis, either the condition is caused by age-related bone loss (sometimes called senile osteoporosis) or the cause is unknown (idiopathic osteoporosis). The term idiopathic osteoporosis is used only for men younger than 70 years old; in older men, age-related bone loss is assumed to be the cause.
The majority of men with osteoporosis have at least one (sometimes more than one) secondary cause. In cases of secondary osteoporosis, the loss of bone mass is caused by certain lifestyle behaviors, diseases, or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications, hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria, and immobilization.
Treatment and Prevention of Osteoporosis in Men
Just like for women, getting enough calcium is very important for preventing osteoporosis. Adults over 50 need 1,200 mg of calcium every day. The best way to get enough calcium is through diet. Buy fortified orange juice and cereals, and eat lots of green leafy vegetables and low-fat dairy products like cheese, milk, ice cream and yogurt.
Your loved one should also get enough vitamin D. If you spend 15 minutes outside in the sun each day, the body should make enough on its own. If you have limited sun exposure, scientists currently recommend 200 to 400 international units (IU) for those under age 70, and 600 for those over 70.
It's also important to do regular weight-bearing exercise, such as walking, jogging, stair-climbing, tennis, weight-training and dancing. These exercises may strengthen bones and may also help with balance. That will reduce your loved one's risk of falling and thus reduce his chances of breaking a bone.
If your loved one already has osteoporosis, doctors are prescribing most of the same medications that they are giving to women. Alendronate and risedronate both now come in a once-a-week pill. But they can cause problems with the stomach or esophagus (the tube that connects the mouth with the stomach) if not taken exactly as directed. The Food and Drug Administration has approved teriparatide only for those who are at high risk of fracture; the drug must be injected daily for no longer than two years. Be sure to talk with your doctor about your options.