MEDICINE - Men and osteoporosis - One in five with bone deterioration is male. Scientists are now looking at risk based on advanced age, low weight and a history of lung disease.
When women reach a certain age, usually 50, their doctors routinely test their bones for signs of osteoporosis. But although men suffer from thinning bones as well, they rarely worry about the condition -- and their doctors rarely test for it.
"This is just not on the radar screen," said Dr. Angela Shepherd, a professor at the University of Texas Medical Branch in Galveston, Texas.
But one in five osteoporosis sufferers are male -- that's 2 million men in the U.S. -- and doctors are slowly starting to take notice.
Shepherd and her colleagues recently used data from nearly 3,000 men to devise a questionnaire that can identify men at risk for osteoporosis. They describe the tool in the current issue of the Annals of Family Medicine. Men or their doctors can use the questionnaire, which gives patients points for advanced age, low weight and a history of lung disease. Those who score six or more points are recommended for X-ray tests that can diagnose osteoporosis.
Doctors don't fully understand why men's bones deteriorate. In women, osteoporosis is associated with menopause, when the body stops producing the high levels of estrogen that protect bones.
"If I see a woman with a bone problem, I can usually figure out what happened," said Dr. Frederick Singer of the John Wayne Cancer Institute in Santa Monica. With more than half of his male patients, however, he sees no obvious reason for their disease. Men often aren't diagnosed until they break a bone.
Though the causes aren't always clear in men, the basic progression of the disease is the same as in women. The body is continually dismantling and rebuilding bones, but after about age 30, the loss rate starts to outpace the growth. If enough bone is lost, it causes osteoporosis, which affects mostly older people. Genes, lifestyle and medical history all play a role in how much bone a person will lose.
Men, who start with bigger, stronger bones, usually get osteoporosis at a later age than women. Patients, male and female, are particularly likely to fracture a hip, spine or wrist, often with life-altering consequences.
"It really affects your life completely, in kind of underground ways that you wouldn't normally think of," said retired engineer Graham Russell, 77, of Santa Monica, who has osteoporosis and started getting fractures around age 40. "Prior to this, if something was in the way, I moved it." Now lifting something heavy could break his bones.
- Feel It in Your Bones May 24, 1999
- Men Also Benefit From Drug That Increases Bone Density Aug 31, 2000
- Osteoporosis Emerges as Growing Public Threat Oct 15, 2004
