Osteoporosis in Men And What Causes It?

Osteoporosis is a condition in which bones become weak and fragile, leading to an increased vulnerability to develop fractures with mild trauma or physical force. Osteoporosis is asymptomatic, you won’t know your bones have become weak until they break with minimal pressure!

This condition is a female condition, is perhaps one of the most common misconceptions! Did you know that approximately 44 million Americans have this condition or osteopenia (low mass of bones), among which 20% are men? Here is what you should know:

• Men over 50 years of age are at 13 to 30% risk of developing bone fractures due to osteoporosis.
• Wrists, hips and spine are the most common areas for fracture.
• Hip fractures are the most lethal or serious fractures.
• Despite the fact, women are at higher risk for osteoporosis, men are at two to three times higher risk of dying due to hip fractures.

What Causes Osteoporosis In Men?

Bone turnover (or wear and tear) is a natural process during which old and worn out bone is replaced by a new and more sturdy, tensile bone. This condition occurs when your body is unable to perform this remodeling process efficiently.

Here Are Some Risk Factors That May Aggravate Your Risk Of Developing Osteoporosis

• Elderly age (70 or above)
• History of fracture at age of 50 or above
• Delayed puberty
• White race
• Thin body structure
• Family history
• Smoking and chronic alcoholism
• Low intake of calcium and vitamin D
• No physical activity
• Hypogonadism (low testosterone)
• Hypercalcemia (higher levels of calcium in blood)
• Liver failure
• Renal failure
• Hyperprolactinemia
• Hyperthyroidism
• Celiac disease
• Some cancers
• Using steroids such as cortisone and prednisone for more than 3 consecutive months can also cause this condition, glucocorticoid-induced osteoporosis

How To Diagnose It In Men?

Based on family history, risk factors and physical examinations, doctor may suspect osteoporosis. Dual-energy x-ray absorptiometry also known as DXA or DEXA scan is the most common diagnostic parameter for osteoporosis. It calculates the bone mineral density (BMD) at spine and hip, and gives scores called T score. T- score ranging between -1.0 and  – 2.5 indicates osteopenia while T score of -2.5 or less indicates this condition. DEXA is also used to locate the fractures in vertebrae.

Other tests include, blood testing (calcium and vitamin D evaluation) and urine tests.

Who Should Get A DEXA Test?

Men who age between 50 and 69 and have certain risk factors should get their BMD checked. Men who are 70 or above should also get their BMD evaluated even if they are not at risk. If doctor suggests DXA, person should get central DXA of the spine and hip. Spine DXA is difficult to be interpreted in adults, in such case BMD can be determined through forearm. Depending upon the condition, another DXA may be required, after 1 or 3 years to determine if there is any further bone loss or to check the treatment responses.

References

• Szulc, P., Kaufman, J. M., & Orwoll, E. S. (2012). Osteoporosis in men. Journal of osteoporosis, 2012.
• Watts, N. B., Adler, R. A., Bilezikian, J. P., Drake, M. T., Eastell, R., Orwoll, E. S., & Finkelstein, J. S. (2012). Osteoporosis in men: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 97(6), 1802-1822.
• Boonen, S., Reginster, J. Y., Kaufman, J. M., Lippuner, K., Zanchetta, J., Langdahl, B., … & Eriksen, E. (2012). Fracture risk and zoledronic acid therapy in men with osteoporosis. New England Journal of Medicine, 367(18), 1714-1723.