OSTEOPOROSIS IS A MEN’S DISEASE, TOO: WHAT AN EXPERT HAS TO SAY

By Doug O’Neill

“Osteoporosis is the silent disease,” says Dr. Aliya Khan, professor of Clinical Medicine, Endocrinology, Metabolism and Geriatrics at McMaster University. “We also call osteoporosis the ‘silent thief’ because it can destroy a person’s bone structure – wreaking havoc on their overall health and vitality – with little warning. While it’s often considered a woman’s disease, osteoporosis also steals the lives of men.

YouAreUnltd asked Dr. Khan,who is also director of the Bone Research & Education Centre in Oakville and director of the Calcium Disorders Clinic at McMaster University in Hamilton, ON, for answers to some common questions about osteoporosis and men. Here’s what she said:

Infographic: Shutterstock.

Is osteoporosis really an issue for men?
One out of every four women and one out of every eight men over the age of 50 develop osteoporosis. Low bone mass and deterioration of bone tissue result in fragile bones that can fracture with limited or no trauma: “Women lose bone density at a much sharper rate when they reach menopause and experience more bone fractures. For men, who are often hesitant to talk about osteoporosis, the deterioration in bone strength is more gradual, often due to aging, various diseases and the side effect of drugs.”

Why do more men die from hip fractures than women?
Studies show that 25 percent of women die within six to 12 months of a hip fracture, whereas the mortality rate for men is 40 percent. “Women who lose bone density as a result of menopause do so much earlier than men,” explains Dr. Khan. “Men experience osteoporotic fractures 10 years later than women. It’s not uncommon to hear of women experiencing hip fractures in their 70s whereas men are more likely to experience hip fractures in their 80s.”

“WE ALSO CALL OSTEOPOROSIS THE ‘SILENT THIEF’ BECAUSE IT CAN DESTROY A PERSON’S BONE STRUCTURE – WREAKING HAVOC ON THEIR OVERALL HEALTH AND VITALITY – WITH LITTLE WARNING.”

That means the male is dealing with age-related illnesses when he’s recovering from a hip fracture – in addition to the impact of major surgery and prolonged bed rest. A prolonged bed rest increases the risk of heart and lung complications, such as pneumonia and heart attacks, as well as an increased risk of blood clots due.

What factors increase a man’s risk of developing osteoporosis?
A man’s risk increases as he ages, but also if he:

  • has a parent who’s had a hip fracture
  • smokes
  • regularly consumes three or more alcoholic drinks per day
  • weighs less than 60 kilograms (132 pounds)
  • is being treated with hormone therapy for prostate cancer
  • lives with a chronic disease such as lung disease, liver disease, kidney disease, diabetes, low testosterone, rheumatoid arthritis, inflammatory bowel disease, celiac disease, cancer, hyperthyroidism or an overactive parathyroid gland.
    Vitamin deficiencies could contribute to osteoporosis. Photo: Flickr/Creative Common, denAsuncioner.
  • has an inadequate intake of calcium or vitamin D
  • leads a sedentary lifestyle.

Is it true that certain medications can impair bone density?
Prednisone, a steroid prescribed a variety of illnesses (arthritis, severe allergies, asthma, skin diseases, cancer, immune system disorders, live and bowel diseases, among others) can weaken bones and lead to osteoporosis. Cancer treatment (chemotherapy and radiation) can also damage the body’s ability to build and repair bones. Frank discussions with your healthcare team is important whenever any medication is prescribed, insists Dr. Khan.

 Other drugs associated with bone loss include anti-seizure medications, certain antidepressants, proton pump inhibitors, and drugs for prescribed for prostate cancer.

Do men exhibit obvious signs and symptoms of osteoporosis?

“A man’s bones can become thinner and more brittle – but an individual cannot feel this loss,” explains Dr. Khan. “That’s why people are often shocked when a simple fall results in a serious, sometimes life-threatening bone fracture. In addition to treating the fracture, it’s equally important to identify the cause.”

The standard rule, according the doctor: “If you break a bone (other than your hands, feet, ankles or face) by falling from standing height, or from the third stair step or lower while running down the stairs – that confirms the presence of osteoporosis by definition. Blood and urine tests can help determine why there is impaired bone strength. We also complete a bone mineral density test (BMD). A bone fracture involving the hip, spine, shoulder or forearm is considered a major osteoporotic fracture and a careful evaluation is necessary.”

Women lose bone density during menopause. Do men experience something similar?

Male menopause, called hypogonadism or andropause, is marked by low testosterone. Men going through this hormonal loss can experience a number of symptoms (low energy, fatigue, decrease in muscle mass, hot flashes, etc.) as well as a loss in height and bone density. “It’s imperative in these cases to check for testosterone levels – but also to determine what’s causing this decrease in testosterone,” advises Dr. Khan.

What medications are prescribed for osteoporosis?
There are various medications that help rebuild bone structure and prevent bone mineral loss. One of the common medications used is denosumab, better known perhaps by its brand name Prolia. “However, many people stop taking their medications during their recovery from hip and other bone fractures,” explains Dr. Khan. “It’s vital to continue to take all prescribed medications.” The good news is that denosumab can now be administered by injection once every six months and is approved by drug plans for both men and women in Canada.

In addition, there is also the bone builder teriparatide (or Forteo), administered daily by injection, which can reverse the osteoporosis process and rebuild the bone.

Lifestyle choices, like limiting alcohol consumption, can reduce the risk of osteoporosis. Photo: Flickr/Creative Commons, Beau Considine.

How do I prevent osteoporosis?
Exercise, good nutrition, proper nutrient intake – especially of calcium and vitamin D – contribute to good bone health. But topping the list: limit alcohol intake and stop smoking! For a full guide to good bone health and osteoporosis prevention, visit the Bone Health section of Osteoporosis Canada: https://osteoporosis.ca/bone-health-osteoporosis

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