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Osteoporosis: Not Just a Female Problem

By KELLY LAWMAN, Beth Israel Deaconess Medical Center Staff

We generally think of osteoporosis as a disease that primarily affects women, and there's good reason for that belief. Nearly half of all women over the age of 50 will suffer an osteoporosis-related fracture, and perhaps because of that, the majority of research about osteoporosis has involved post-menopausal women. What you may not know is that 1 in 4 men over the age of 50 will also experience a fracture related to bone loss.

Elderly
(PATRICK PLEUL/AFP/Getty Images)

"Especially, as we age, it's important to remember that osteoporosis is not just a woman's disease," said Tamara Rozental, MD, Department of Orthopaedics at Beth Israel Deaconess Medical Center and Associate Professor at Harvard Medical School. "Both women and men should be thinking about their bone health and talking with their doctors about their risk for bone loss and osteoporosis."

Throughout our lives, our bodies are constantly making new bone tissue (ossification) and breaking down older bone tissue (resorption), through a process known as bone remodeling or bone metabolism. We start to lose bone density when the body breaks down more bone tissue than we're generating. It happens to all of us as we get older.

"Women generally have thinner bones to start with, and as women age and lose estrogen, ossification slows. As a result, the bones can become weak, brittle and more prone to fracture," said Rozental. "The same thing can happen as men start to lose testosterone with age, though we tend to see it a little later than we do with women."

The most common osteoporosis-related fractures happen in the hip, spine or wrist. And a wrist fracture can be an early signal for future risk.

"We often see wrist fractures in both men and women about 10 to 15 years before we might see a fracture to the spine or hip," said Rozental. "If you've had a fracture of the wrist, you should talk with your doctor about getting a bone mineral density (BMD) evaluation, and if necessary, work with your medical team to start treatment with the goal of preventing a more serious fracture down the line."

Studies continually show that the overall number of people who receive bone mineral density screenings is unacceptably low for everyone, but especially among men. A recent study conducted by Rozental found that following a wrist fracture, 53 percent of women received a bone density test, compared with only 18 percent of men. Additionally, 21 percent of men versus 55 percent of women started treatment with calcium and vitamin D supplements within six months of their injury, and three percent of men compared with 22 percent of women started taking bisphosphonates, a common drug treatment for increasing bone mass.

"These numbers matter," said Rozental. "Studies have shown that men have twice the mortality rate of women both during initial hospitalization and in the year following a hip fracture. Survival rates following a risk fracture, the most common upper extremity fracture in older adults, also are lower among men."

The bottom line is talk with your doctor about your bone health. Be proactive about getting a bone density test when you reach 50 if you're a woman and 65 if you're a man, earlier if you've had a fracture.

And in the meantime, treat your bones right. Eat a healthy diet rich in calcium and vitamin D, maintain a healthy weight, limit alcohol intake, quit smoking and continue to exercise. Exercise, combining strength training and weight bearing exercises, can help prevent bone loss and strengthen weakened bones.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted December 2014

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