Q. My male friend was recently diagnosed with osteoporosis. I have always heard this was something that affected women. How common is this in males, and are the methods of prevention the same for men as they are for women?
A. While not as common in men as in women, osteoporosis affects approximately 1.5 million men in the United States, and 3.5 million men are at risk. Lifestyle modifications should be encouraged in all men to reduce their risk. These include: regular weight bearing exercise, eliminating cigarette smoking and avoiding excessive alcohol intake.
Osteoporosis is a silent disease that usually is not identified in men until the development of fractures. Men with osteoporosis should receive adequate calcium (1000 mg/ day in younger men, 1200-1500 mg/day in older men) and vitamin D (400-800 international units/day). They should also be screened for diminished testosterone levels and treated with testosterone replacement if their levels are low (unless contraindicated), as this is among the most commonly identifying causes in men. Offending agents such as tobacco, alcohol and chronic steroid use should be eliminated if possible. Screening for other secondary medical causes should be accomplished as directed by their personal physicians.
Men can be treated with the same medications as recommended for women such as Fosamax, Actonel, Boniva or Reclast. There is currently no data supporting routine screening for osteoporosis in men via bone density examinations unless there is evidence of bone thinning on X-rays, a history of low trauma fractures, loss of more than 1.5 inches of height, long-term steroid therapy, hyperparathyroidism or intestinal disorders which could lead to vitamin or mineral deficiencies.
Kimberly Carlton, M.D.
Board Certified Family Medicine
Erlanger North Family Medicine
632 Morrison Springs Road, Suite 202
Chattanooga, TN 37415