Osteoporosis And Bone Density In Men

Osteoporosis isn’t only a women’s disease. This condition also weakens bones in older men.

As we age, every adult loses bone density — bone strength that protects us from fractures. Bone density typically peaks in early adulthood and then starts to decline, said Samuel Worsham, DO, an endocrinologist with the Franciscan Physician Network in Lafayette, Indiana.

Although osteoporosis is four times more common in women, older men aren’t immune. Here’s what Dr. Worsham said men need to know about their risk of osteoporosis, its causes and how they can prevent fractures.

Key Takeaways: Osteoporosis And Bone Density In Men

• Men lose bone as they age, which increases their risk of osteoporosis and bone fracture.
• Bone density testing detects low bone mass before you experience serious complications.
• Lifestyle changes, medical treatment and supplements help men protect their bone health and maintain strength.

Do Men Get Osteoporosis?

Yes, men can get osteoporosis. It can develop in men over age 50, but it’s more likely after age 65. Roughly 2 million American men have osteoporosis, and 12 million more are at risk.

Just like women, men can experience osteoporosis-related fractures. Up to 25 percent of men will break a bone related to this condition, including one-third of all hip fractures each year.

Osteoporosis In Men Vs. Women: How It Differs

Osteoporosis develops differently in men than in women. The condition still weakens your bones. But men reach peak bone mass earlier and maintain it longer. So, bone loss happens at a slower rate, and symptoms take longer to appear.

Older men also experience fewer osteoporosis-related fractures. The first fracture typically happens 10 years later than in women. However, the older you get, the greater your risk of complications or dying if you break a bone.

Why Men Lose Bone Density: Hormones, Testosterone And Risk Factors

Men lose bone density for many of the same reasons that women do, including family history and lack of exercise, Dr. Worsham said. Other similar factors include:

• A low testosterone level
• Long-term steroid use
• Low calcium (below 1,200 mg daily) and vitamin D
• Smoking
• Too much alcohol use

Other factors have a greater impact on men. In many cases, underlying health behaviors and factors are responsible, including:

• Being over 70
• Certain chronic conditions, like diabetes, kidney disease and rheumatoid arthritis
• Endocrine disorders
• Gastrointestinal disease
• Hormone suppression from prostate cancer treatment
• Low estrogen level
• Lung disease
• Parkinson’s disease
• Poor calcium intake

Bone density testing for men: who needs a DEXA scan and when?

All men over 70 should have bone density screening. If you’ve been diagnosed with low testosterone or have other risk factors, you should start screening by age 50.

This screening, called dual-energy X-ray absorptiometry (DXA), is an X-ray scan that measures the amount of calcium and other minerals in specific parts of your bones. Based on your age, your scan results give your bone mineral density a T-score or a Z-score:

• T-score: If you’re over 50, this score is the difference between your bone mineral density and the average bone mineral density of a young, healthy adult. Scores of -2.5 and below usually indicate osteoporosis.
• Z-score: If you’re under 50, this score is the difference between your bone mineral density and the average density of people your age, ethnicity and sex. Scores of -2.0 or lower point to rapid bone loss linked to medications, medical conditions or hormonal imbalance.

Treatment And How Men Can Increase Bone Density

Osteoporosis treatment for men can include a mix of lifestyle changes and medications. If you’re diagnosed with osteoporosis, you can adopt these healthy behaviors to help improve your condition:

• Eat a balanced diet that’s rich in dairy and protein
• Increase exercise (include cardiovascular activity and 30–40 minutes of weight-bearing exercise 3–4 times a week)
• Limit alcohol consumption
• Reduce fall risks at home (clear walking paths, improve lighting, and remove or secure rugs)
• Stop smoking

Fewer osteoporosis medications are available for men than for women. Most focus on increasing bone mineral density and preventing spine fractures. If appropriate, your doctor may recommend one or more of these medications:

• Anabolic treatment with parathyroid hormones
• Bisphosphonates
• Monoclonal antibodies
• Testosterone therapy

How To Prevent Fractures

Many of the same healthy lifestyle behaviors mentioned above can help you prevent osteoporosis-related fractures, said James Hartson, MD, a Michigan City, Ind., orthopedic surgeon at Franciscan Health Network Coolspring Health Center. You can also build stronger bone density and avoid broken bones when you keep your muscles loose.

“As we age, flexibility becomes increasingly important. The less flexible the muscles and tendons, the increased risk of strains, tears and ruptures,” he said. “Therefore, I would recommend a good flexibility class or yoga.”