Washington, USA
— Most people don't think that men develop
osteoporosis. This disease, in which bone becomes thin
and fragile and can fracture easily, is mostly associated
with women. Doctors don't often discuss the issue with
their male patients. But men can get the hip and other
bone fractures that come with osteoporosis, too, and it's
no less painful or debilitating for them than it is for
women.
Men are usually diagnosed
with osteoporosis only when they have fractured a bone.
Men don't generally experience the rapid bone loss in
their 50's that women do, but by age 65 or 70, they are
losing bone mass at the same rate as women.
Hip fractures occur at
older ages in men, which might explain why men who break
a hip are more likely to die of complications than women.
More than half of all men who suffer a hip fracture go
from the hospital to a nursing home, and 79 percent of
those who survive for one year still live in nursing
homes or intermediate care facilities.
Studying Osteoporosis in
Men
Scientists are trying to
learn more about the causes, diagnosis, treatment and
prevention of osteoporosis and its related fractures in
men as well as in women. In 1999, NIH's National
Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS) <http://www.niams.nih.gov/>,
and two other NIH components, the National Institute
on Aging (NIA) <http://www.nia.nih.gov/>
and the National Cancer Institute (NCI)
<http://www.cancer.gov/>,
launched a seven-year study that is following 5,700 men,
age 65 or older. "Mr. OS," as it is called, aims to
determine the extent to which the risk of fractures in
men is related to bone mass and other factors such as
their bone structure, lifestyle and tendency to
fall.
In the NCI component of
"Mr. OS," scientists are trying to answer the question of
whether having a high bone mass is associated with an
increased risk of prostate cancer. In women, if you have
a high bone mass, you have a higher risk of getting
breast cancer. Both types of cancers are thought to be
associated with your whole lifetime exposure to the sex
hormones your own body makes.
NIH's National Heart,
Lung, and Blood Institute (NHLBI) <http://www.nhlbi.nih.gov/>
is also supporting a part of "Mr. OS" that is looking at
the role of sleep in the health of older men.
Treatment and
Prevention
Men are more likely than
women to have a high risk of fracture due to secondary
causes, like a specific disease (such as celiac disease,
in which a person's intolerance to a protein found in
wheat and other grains interferes with their intestinal
absorption of calcium) <http://en.wikipedia.org/wiki/Celiac_disease>
or taking medications that can affect bone mass (like the
steroids used to treat asthma, rheumatoid arthritis and
other diseases). Knowledge of the diseases and conditions
that can affect bone mass can help to prevent men as well
as women from reaching the point of fracture before
diagnosis.
Getting enough calcium is
very important for preventing osteoporosis. Adults 19 -
50 years old need 1,000 milligrams (mg) of calcium every
day; those over 50 need 1,200 mg. The best way to get
enough calcium is through your diet. Buy fortified orange
juice and cereals, and eat lots of green leafy vegetables
and low-fat dairy products like cheese, milk, ice cream
and yogurt.
You should also get
enough vitamin D. If you spend 15 minutes outside in the
sun each day, your body should make enough on its own. If
you have limited sun exposure, scientists currently
recommend 200 to 400 international units (IU) if you are
under age 70 and 600 if you are over.
It's also important to do
regular weight-bearing exercise, such as walking,
jogging, stair-climbing, tennis, weight-training and
dancing. These exercises may strengthen your bones and
may also help with your balance. That will reduce your
risk of falling and thus reduce your chances of breaking
a bone.
If you already have
osteoporosis, doctors are prescribing most of the same
medications that they are giving to women. Alendronate
(brand name Fosamax®) and risedronate (brand name
Actonel®) both now come in a once-a-week pill. But
they can cause problems with your stomach or esophagus
(the tube that connects the mouth with the stomach) if
not taken exactly as directed. The Food and Drug
Administration <http://www.fda.gov/>
has approved teriparatide (brand name Forteo®) only
for those who are at high risk of fracture; the drug must
be injected daily for no longer than two years. Be sure
to talk with your doctor about your options.
