While women are more likely to get osteoporosis than men, it doesn’t mean men shouldn’t be concerned. Experts estimate that one-fifth to one-third of all hip fractures occur in men and that symptomatic vertebral (spine) fractures occur about half as often in men as in women. After age 50, six percent of all men will suffer a hip fracture as a result of osteoporosis.
Osteoporosis develops less often in men than in women because men have larger skeletons, bone loss starts later and progresses more slowly, and there is no period of rapid hormonal change and accompanying rapid bone loss. However, by age 70, men lose bone mass at the same rate as women. Plus, because the age of onset is later, the complications from broken bones can be more serious. Men need to ensure they are taking care of their bone health, too, starting early.
There are two main types of osteoporosis: primary and secondary. In cases of primary osteoporosis, the condition is either 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 less than 70 years old; in older men, age-related bone loss is assumed to be the cause.
At least half 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 medication, low levels of testosterone, alcohol abuse, smoking, gastrointestinal disease, hypercalciuria and immobilization.
- Smoking – Bone loss is more rapid, and rates of hip and vertebral fracture are higher, among men who smoke, although more research is needed to determine exactly how smoking damages bone. Tobacco, nicotine and other chemicals found in cigarettes may be directly toxic to bone or they may inhibit absorption of calcium and other nutrients needed for bone health. Quitting is the ideal approach, of course, as smoking is harmful in so many ways. But again, as with alcohol, it is not known whether quitting smoking leads to reduced rates of bone loss or to a gain in bone mass.
- Gastrointestinal Disorders – Several nutrients, including amino acids, calcium, magnesium, phosphorous and vitamins D and K are important for bone health. Diseases of the stomach and intestines can lead to bone disease when they impair absorption of these nutrients. Treatment for bone loss in this case may include supplementation of the poorly absorbed nutrient(s).
- Alcohol Abuse – There is a wealth of evidence that alcohol abuse may decrease bone density and lead to an increase in fractures. Low bone mass is found in 25 to 50 percent of men who seek medical help for alcohol abuse. One early study found the bone mass of young alcoholic males to be comparable to that of elderly females.
There are several risk factors that have been linked to osteoporosis in men:
- Chronic diseases that affect the kidneys, lungs, stomach, and intestines or alter hormone levels.
- Undiagnosed low levels of the sex hormone testosterone.
- Unhealthy lifestyle habits (e.g., smoking, excessive alcohol use, low calcium intake, inadequate physical exercise).
- Age: the older you are, the greater your risk.
- Heredity: a son is almost four times as likely to have low bone mineral density (BMD) if his father has low BMD, and nearly 8 times as likely if both parents have low BMD.
- Race: Caucasian men appear to be at particularly high risk, but all men can develop this disease.
You can take steps to protect yourself. Eating foods rich in vitamin D and calcium is a good start. High quality supplements can help give you those essential bone-building nutrients if you’re not getting them in what you eat.