Bone Health Matters: Breaking the Silence on Osteoporosis in Men

Article by Dr. Donald Greig

When we think of osteoporosis, many of us immediately associate it with women, particularly postmenopausal women. However, osteoporosis is not exclusive to women—it also affects men, though it’s often overlooked. This oversight can have serious consequences, as men are at significant risk of fractures due to osteoporosis, especially as they age. In this newsletter, we’ll explore the importance of bone health in men, the risks of osteoporotic fractures, why men should consider a DEXA bone scan, and the steps that can be taken to strengthen bones and reduce bone loss.

What Is Osteoporosis?

Osteoporosis is a condition characterized by a decrease in bone density and strength, leading to fragile bones that are more prone to fractures. While women are generally more likely to develop osteoporosis due to hormonal changes after menopause, men are far from immune to this silent disease.

In men, bone density begins to decline around the age of 30, and this process accelerates after the age of 50. By the time men reach their 70s, their risk of osteoporotic fractures increases significantly. Despite this, osteoporosis in men often goes undiagnosed and untreated until a serious fracture occurs, such as a broken hip, spine, or wrist.

Why Should Men Be Concerned About Osteoporosis?

Although women are more likely to develop osteoporosis, men face a higher risk of complications and mortality after osteoporotic fractures. Studies show that men account for up to 30% of all hip fractures, and their mortality rate within the first year after a hip fracture is twice as high as that of women. Why? Men are often older at the time of diagnosis, and their fractures are more likely to be complicated by other health problems.

Comparing Risks for Men and Women

• Incidence: Women are more likely to develop osteoporosis, but men are less likely to be screened or treated.

• Fracture Outcomes: Men with osteoporotic fractures are more likely to experience disability, slower recovery, and complications.

• Awareness Gap: Osteoporosis in men is underdiagnosed and undertreated, often considered a "woman's disease."

The Importance of a DEXA Bone Scan for Men

One of the most effective ways to assess bone health is through a DEXA (Dual-Energy X-ray Absorptiometry) scan, a quick and painless test that measures bone density. While many women are advised to undergo bone density testing after menopause, men are often overlooked for this screening.

Who Should Get a DEXA Bone Scan?

Men should consider a DEXA scan if they:

• Are over the age of 70, regardless of risk factors.

• Are between 50 and 69 years old and have risk factors for osteoporosis, such as: 

  • A history of fractures after minor injuries.

  • Chronic use of corticosteroids (e.g., prednisone).

  • Smoking or excessive alcohol consumption.

  • Low testosterone levels (hypogonadism).

  • Chronic medical conditions like rheumatoid arthritis, diabetes, or gastrointestinal disorders.
    

What to Expect During a DEXA Scan

• The DEXA scan is a non-invasive, painless procedure that typically takes about 10-20 minutes.

• You’ll lie on a table while a machine scans your hip, spine, or other bones to measure bone mineral density (BMD).

• The results will be compared to standard BMD levels, allowing your doctor to determine your risk of fracture and whether treatment is needed.

How Can Men Strengthen Bones and Reduce Bone Loss?

While a diagnosis of osteoporosis may sound alarming, there are many steps that men can take to improve their bone health and reduce the risk of fractures.

1. Nutrition for Strong Bones

• Calcium: Ensure adequate calcium intake to maintain bone strength. Men aged 50-70 need about 1,000 mg of calcium daily, increasing to 1,200 mg after age 70. Good sources include dairy products, leafy greens, fortified plant-based milks, and almonds.

• Vitamin D: Vitamin D helps your body absorb calcium. Men need 600-800 IU (international units) daily, which can be obtained from sunlight exposure, fatty fish, fortified foods, or supplements.

2. Exercise Regularly

Engage in weight-bearing and resistance exercises, which are key to maintaining and building bone density:

• Weight-bearing exercises: Walking, jogging, dancing, or hiking.

• Strength training: Using weights or resistance bands to build muscle and strengthen bones.

• Balance and flexibility exercises: Yoga or tai chi to reduce the risk of falls.

3. Lifestyle Changes

• Quit Smoking: Smoking reduces bone mass and increases fracture risk.

• Limit Alcohol: Excessive alcohol consumption interferes with calcium absorption and bone formation. Limiting intake to 1-2 drinks per day is recommended.

• Healthy Weight: Being underweight or overweight can impact bone health. Maintaining a healthy weight is crucial.

4. Medications

If diagnosed with osteoporosis, your doctor may recommend medications to slow bone loss or promote bone growth:

• Bisphosphonates: These are the most common medications for osteoporosis and help prevent bone breakdown.

• Testosterone Replacement Therapy: For men with low testosterone, this may help improve bone density.

• Other Medications: Denosumab, teriparatide, or romosozumab may be prescribed, depending on your specific risk factors and bone health.

5. Prevent Falls

Since fractures often result from falls, take steps to reduce your fall risk:

• Use non-slip mats in the bathroom and kitchen.

• Ensure your home has adequate lighting.

• Wear supportive shoes with non-slip soles.

• Consider a physical therapy program to improve balance and coordination.

Take Action Today

Osteoporosis in men is a serious but preventable condition. Early detection through a DEXA bone scan can identify bone loss before fractures occur, allowing for timely intervention. By focusing on proper nutrition, regular exercise, and lifestyle changes, men can significantly reduce their risk of fractures and maintain strong, healthy bones as they age.

If you’re a man over 50 or have risk factors for osteoporosis, talk to your doctor about whether a DEXA scan is right for you. Remember, it’s never too late to take charge of your bone health and prevent the complications of osteoporosis.

Stay strong, stay active, and take care of your bones today!

Disclaimer: This newsletter is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider for any medical concerns.