Osteoporosis, a disease that causes bones to weaken and sometimes break, is often thought of as a "women's disease," but it poses a significant threat to more than 2 million men in the United States, according to the National Institutes of Health.
For most of their lives, men generally have a lower risk of developing osteoporosis than women. But by age 65 or 70, men and women lose bone mass at the same rate, and the absorption of calcium — an essential nutrient for bone health throughout life — decreases in both sexes, the NIH said.
Excessive bone loss can lead to fractures, most often in the hip, spine and wrist.
After age 50, 6 percent of all men will experience a hip fracture and 5 percent will have a spinal fracture as a result of osteoporosis, NIH has reported.
"It is a silent disease until a fracture occurs," said Dr. Christine Simonelli, medical director of HealthEast Osteoporosis Care in the Woodbury Clinic.
Perhaps because such fractures tend to occur at older ages in men than in women, men who suffer hip fractures are more likely than women to die from complications, according to the NIH.
In men, the disease "is an area, you could say, that's forgotten almost," said Bob Schmaltz, radiology assistant with Altru Health System in Grand Forks, N.D.
Recognition of male osteoporosis as a public health issue has grown, particularly in light of estimates that the number of men older than 70 will continue to increase as life expectancy continues to rise.
"We're getting into the situation where almost everyone who extends out their life expectancy is going to have osteoporosis," Simonelli said.
Risk factors
Because women live longer, they are more likely to get the disease, Schmaltz said. "There are four times as many women who have osteoporosis than men."
Traditional lifestyles may also be a factor in protecting men from osteoporosis. "Generally — and I'm speaking generally now — men are more physically active during their lives," he said. "They're engaging in heavier work."
Physical activity and weight-bearing exercise have been shown to play an important part in building and maintaining bone density. But some lifestyle behaviors, such as extensive alcohol use and smoking, contribute to their risk. "Smokers have a higher rate of fractures," Schmaltz said.
The male difference
Because men have larger skeletons, their bone loss starts later and progresses more slowly. They also have no period of rapid hormonal change and bone loss, as women do after menopause, according to the NIH.
Bone is constantly changing — that is, old bone is removed and replaced by new bone. During childhood, more bone is produced than removed, so the skeleton grows in both size and strength. For most people, bone mass peaks during their 20s. By this age, men typically have accumulated more bone mass than women. After this point, the amount of bone in the skeleton typically begins to decline slowly as removal of old bone exceeds formation of new bone.
"Bone continually monitors what stress we put on it," Schmaltz said. "With bone mass, it's a 'use-it-or-lose-it' proposition, much like muscle."
Causes in men
The most common cause of male osteoporosis is testosterone deficiency, an area that needs more scientific attention, Schmaltz said. In addition, several medications — such as steroids and drugs for prostate cancer and seizures — can affect bone mass, he said. Conditions such as rheumatoid arthritis, digestive and blood disorders, and cystic fibrosis play a role in developing osteoporosis, because they can impair the body's ability to absorb needed nutrients. Bone loss is a common side effect of drugs used to treat asthma and rheumatoid arthritis, according to the NIH.
Prevention
Lifestyle choices can help prevent osteoporosis, including eating a balanced diet with a lot of calcium and vitamin D-rich foods, and taking supplements, if your doctor prescribes them.
Exercise — such as brisk walking at least 30 minutes a day — and weight-bearing exercises can help strengthen bones.
If you have concerns about bone-density loss, see your doctor. "It's better to be proactive than waiting for something to happen," Schmaltz said.
Staff Writer Allie Shah contributed to this report.
