Osteoporosis, a condition that causes bones to become weak and brittle, is frequently perceived as a health issue exclusive to women. This perception is incorrect, as men can and do develop the disease. Though men build more bone mass in their youth and do not experience the rapid hormonal shifts of menopause, they are still susceptible to progressive bone loss. The consequences for men can be significant, as they have a higher mortality rate following an osteoporotic fracture. Recognizing this condition as a serious health concern for men is the first step toward better prevention and management.
Risk Factors for Osteoporosis in Men
The risk of developing osteoporosis in men stems from a combination of unavoidable biological factors and modifiable lifestyle choices. A primary factor is the aging process, as bone density peaks in a person’s late 20s and begins a gradual decline around age 35. By the time men reach 65, they lose bone mass at the same rate as women, increasing their fracture risk. A family history of osteoporosis or a parental history of hip fracture also elevates a man’s risk.
Secondary factors related to other health conditions and lifestyle habits play a large part in the development of osteoporosis. Low levels of the male hormone testosterone, a condition known as hypogonadism, is a common cause because it helps maintain healthy bones. Long-term use of certain medications, such as steroid tablets for conditions like asthma or arthritis, can interfere with bone health.
Excessive alcohol consumption can disrupt the body’s ability to absorb calcium. Smoking is another contributor, as it can reduce the blood supply to the bones and slow the production of bone-forming cells. Chronic conditions affecting the kidneys or liver, as well as long periods of inactivity, further increase a man’s susceptibility to significant bone loss.
Identifying the Condition
Osteoporosis is often called a “silent disease” because it progresses without any symptoms until a bone breaks. A fracture resulting from a minor fall or a seemingly harmless action like coughing is frequently the first indication of the underlying condition. These incidents, known as fragility fractures, most commonly involve the hip, spine, or wrist. Over time, multiple small fractures in the spine can lead to a noticeable loss of height or the development of a stooped posture.
Because outward signs are absent in the early stages, a definitive diagnosis relies on measuring bone mineral density (BMD). The most widely used test is a dual-energy x-ray absorptiometry (DEXA) scan, which measures mineral content in specific bones, typically the hip and spine. The results are reported as a “T-score,” comparing an individual’s bone density to that of a healthy young adult. A T-score of -2.5 or lower is classified as osteoporosis, while a score between -1.0 and -2.5 indicates osteopenia, a state of lower-than-normal bone density.
Strategies for Prevention and Treatment
The approaches for preventing and treating osteoporosis in men are closely linked, focusing on lifestyle modifications and, when necessary, medical intervention. A foundational strategy is ensuring an adequate intake of calcium and vitamin D. Men aged 51 and older should aim for 1,200 mg of calcium daily through sources like dairy products, leafy green vegetables, and fortified foods. Vitamin D, which aids calcium absorption, can be obtained through sunlight exposure and supplements.
Regular physical activity is another component of bone health. Weight-bearing exercises, which force the body to work against gravity, directly stimulate bone-forming cells. Activities such as walking, jogging, and climbing stairs are effective at strengthening bones. Muscle-strengthening exercises, including lifting weights, also contribute to building stronger bones and improving balance to help prevent falls.
For men diagnosed with osteoporosis or those at high risk, a doctor may recommend medication. Bisphosphonates are a class of drugs commonly prescribed to slow bone loss and reduce fracture risk. In cases of severe osteoporosis or for men with hypogonadism, other treatments like teriparatide or testosterone therapy may be considered. Any man concerned about his risk should consult a healthcare provider to develop a personalized plan that may include lifestyle adjustments, supplements, and appropriate medical treatments.