Osteoporosis is often considered a women’s disease as it is more common in menopausal and postmenopausal women. Most men tend to ignore their risk of developing osteoporosis and do not take any measures to improve their bone health. Do you know the risk of osteoporosis in men?

However, the fact is osteoporosis can affect men too. 

It is estimated that 1 in 5 men above the age of 50 years can have a fracture due to osteoporosis. [1]

There is a need to be aware that osteoporosis can also affect men. Men should know the risk factors of osteoporosis to reduce their chances of developing serious complications. Read on to learn more about the risk of osteoporosis in men.  

The development of osteoporosis in men 

During childhood, the rate of formation of bone is higher than the rate of bone loss. Dead and damaged bone cells can be replaced by healthy cells more efficiently keeping the bones strong. [2]

This process helps in the growth of the skeleton during the early years of development. The bone mass continues to rise as the child grows and peaks during young adulthood. At this age, most men have built more bone mass compared to women. 

However, as men enter their 50s, the rate of removal of dead bone cells exceeds the rate of formation of new cells. As a result, the amount of bone mass begins to decline slowly. 

Men in their 50s usually do not experience the loss of bone mass as women do during menopause. By the age of 65 to 70 years, however, men too start losing bone mass rapidly at the same rate as that of women as the absorption of calcium in the intestine reduces in both genders. 

The excessive bone loss at this age can make the bones porous and fragile thus increasing their risk of osteoporosis. 

These changes occur as a part of the body’s aging process marked by the degeneration of tissues. This is an inevitable process and is why men must not ignore their risk of developing osteoporosis. [3]

Before we learn more about the risk of osteoporosis in men, let’s look at some facts and statistics: [4]

• Men older than 50 years are more likely to have osteoporosis-induced fractures than they are to develop prostate cancer.
• It is reported that nearly 80,000 men suffer from a hip fracture every year.
• The osteoporosis-linked fractures are more likely to occur in the spine and hip bones in men. However, this usually occurs at a later age compared to women.
• Since men are usually older when they develop their first fracture, they are likely to experience more serious consequences than women.
• Men who develop a fracture have a higher risk of mortality than women.

The risk factors for osteoporosis in men 

1. Age 

The risk of osteoporosis increases with age. About 4 to 6% of men above 50 years of age have osteoporosis, while 33 to 47% of men of the same age have osteopenia. 

The chances of breaking the hip bone can also go up as age increases. About one in four men above 50 years of age have a fracture due to osteoporosis. [5]

2. Race 

It has been found that the prevalence of osteoporosis is lower in Hispanic-American men than in white men. 

3. Glucocorticoid therapy 

Long-term use of glucocorticoid medications accounts for 1 in 6 cases of osteoporosis in men. The extent of bone loss is more severe in men who receive glucocorticoid therapy in a higher dose or for a longer duration. 

Hence, men are advised to seek proper treatment of osteoporosis while undergoing glucocorticoid therapy. The treatment may involve the use of medications such as bisphosphonates and supplements containing calcium and vitamin D. [6]

4. Side effects of medications

Some medications can trigger faster bone loss making men prone to develop osteoporosis at a younger age.

For example; anticonvulsant medications such as phenytoin and phenobarbital are known to contribute to the pathogenesis of osteoporosis by affecting calcium metabolism. [7]

5. Reduced androgen levels

Androgens are hormones that are required for attaining and maintaining a peak bone mass. The production of androgens such as testosterone is reduced in young men who suffer from Hypogonadism. 

The reduced testosterone levels can lower their bone density making them prone to develop osteoporosis. Testosterone replacement therapy can be beneficial in such cases to prevent osteoporosis. [8]

6. Smoking

Research studies have revealed that the incidence of osteoporosis is higher in smokers than in non-smokers. Smoking is also linked to an increased risk of osteoporotic fractures. 

Tobacco-linked bone loss is dependent on the duration and quantity of smoking. Men are advised to quit smoking to improve their bone health and prevent osteoporosis. [9]

7. Alcohol intake

While the consumption of alcohol in modest amounts may produce a protective effect on your bones, its sustained and high consumption can trigger faster bone loss. Alcohol can produce a toxic effect on the osteoblasts that produce new bone cells. 

Limit your alcohol intake to protect your bones and reduce the chances of developing osteoporosis. [10] [11]

https://www.aafp.org/afp/2003/0401/p1521.html

When should men have bone mineral density tests? 

Men above the age of 50 are advised to undergo regular bone mineral density tests, especially if they have risk factors such as glucocorticoid therapy, a family history of osteoporosis, or smoking. [12]

Men above 50 who have lost more than 1.5 inches of height also need to undergo bone density tests to screen for osteoporosis. [13]

Conclusion

Most men are under the impression that osteoporosis affects only women. However, they must keep in mind that though this disease is more common in women, it can affect men too.

Men are advised to assess their chances of developing osteoporosis based on the presence of risk factors. They should also undergo regular bone mineral density tests. This will help them maintain optimum bone health and reduce the risk of osteoporosis and fractures.

References:

1. https://www.iofbonehealth.org/osteoporosis-men
2. https://familydoctor.org/condition/osteoporosis/
3. https://www.iofbonehealth.org/osteoporosis-men
4. https://www.nof.org/preventing-fractures/general-facts/just-for-men/
5. https://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html
6. https://www.ncbi.nlm.nih.gov/books/NBK278968/
7. https://www.epilepsysociety.org.uk/should-you-worry-about-osteoporosis
8. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302006000400021
9. https://medlineplus.gov/ency/patientinstructions/000506.htm
10. https://creakyjoints.org/diet-exercise/alcohol-and-osteoporosis/
11. https://www.sciencedirect.com/science/article/abs/pii/S0376871619300584#!
12. https://www.cdc.gov/genomics/disease/osteoporosis.htm
13. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-do-you-need-a-bone-density-test/