Submitted by Shannon Laesch, APN, and Elizabeth Madlem, APN, The Bone Health Clinic at Millennium Pain Center
Osteoporosis is a disease that causes the skeleton to weaken and the bones to break. It poses a significant threat to millions of men in the United States. However, the majority of American men view osteoporosis solely as a “woman’s disease.” Moreover, among men whose lifestyle habits put them at increased risk, few recognize the disease as a significant threat to their mobility and independence.
Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs. It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss. However, in the past few years the problem of osteoporosis in men has been recognized as an important public health issue, particularly in light of estimates that the number of men above the age of 70 will continue to increase as life expectancy continues to rise.
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 the third decade of life. 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.
Men in their fifties do not experience the rapid loss of bone mass that women do in the years following menopause. By age 65 or 70, men and women are losing bone mass at the same rate, and the absorption of calcium, an essential nutrient for bone health throughout life, decreases in both sexes. Excessive bone loss causes bone to become fragile and more likely to fracture.
Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Perhaps because such fractures tend to occur at older ages in men than in women, men who sustain hip fractures are more likely than women to die from complications.
What causes osteoporosis in men?
Osteoporosis is usually caused by age-related bone loss. However, the majority 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 the following:
- Glucocorticoid medications: Glucocorticoids are steroid medications used to treat diseases such as asthma and rheumatoid arthritis. Bone loss is a very common side effect of these medications.
- Hypogonadism: Hypogonadism refers to abnormally low levels of sex hormones. It is well known that loss of estrogen causes osteoporosis in women. In men, reduced levels of sex hormones may also cause osteoporosis. Although it is natural for testosterone levels to decrease with age, there should not be a sudden drop in this hormone that is comparable to the drop in estrogen experienced by women at menopause.
- Alcohol abuse: There is a wealth of evidence that alcohol abuse may decrease bone density and lead to an increase in fractures.
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. - 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.
- Immobilization: Weight-bearing exercise is essential for maintaining healthy bones. Prolonged bed rest (following fractures, surgery, spinal cord injuries, or illness) often results in significant bone loss.
Osteoporosis can be effectively treated, especially if it is detected before significant bone loss has occurred. A comprehensive osteoporosis treatment program includes a focus on lifestyle changes, such as proper nutrition and exercise, as well as safety issues to prevent falls that may result in fractures.
For more information on osteoporosis, you may contact The Bone Health Clinic at Millennium Pain Center, 309-662-4321. They are located at 1015 Mercer Ave. in Bloomington. Shannon Laesch and Elizabeth Madlem are certified bone health consultants. The clinic provides screening, diagnosis, and a comprehensive treatment plan for people who have or are at risk of developing osteoporosis.