Men Face Osteoporosis Risk: Why Screening Is Crucial

A recent study reveals that osteoporosis is a significant health risk for men, challenging the notion that brittle bones predominantly affect women. In 2006, while biking in North Wales, Pennsylvania, Ronald Klein experienced a seemingly minor accident that led to a serious revelation about his bone health. After falling and fracturing his hip and shoulder, Klein learned he had developed osteoporosis, a condition that weakens bones and increases the risk of fractures.

The situation is alarming; approximately one in five men over the age of 50 will experience an osteoporotic fracture in their lifetime. Among older adults, men account for about a quarter of hip fractures. Dr. Cathleen Colon-Emeric, a geriatrician at the Durham VA Health Care System and Duke University, points out that men face worse outcomes following such fractures, with mortality rates reaching as high as 30 percent within a year.

In a study involving 3,000 veterans aged 65 to 85, only 2 percent of those in the control group had undergone bone density screening. According to Dr. Douglas Bauer, an osteoporosis researcher at the University of California, San Francisco, this rate is “shockingly low.” However, implementing a dedicated bone health service led to significant improvements. In the intervention group, 49 percent agreed to screening, and half of those tested were found to have osteoporosis or a precursor condition known as osteopenia.

Understanding Osteoporosis in Men

Despite the known risks, many men and health care professionals view osteoporosis as a women’s issue. Many men, like 74-year-old Bob Grossman, remain unaware of their risks. After resisting his wife’s suggestions to seek help for his visibly rounded upper back, he learned he had osteoporosis. This misconception is compounded by inconsistent clinical practice guidelines.

Organizations such as the Endocrine Society and the American Society for Bone and Mineral Research recommend screening men over 50 with risk factors and all men over 70. In contrast, the American College of Physicians and the U.S. Preventive Services Task Force deem the evidence for screening men insufficient.

This disparity has significant implications. While osteoporosis treatments have proven effective in increasing bone density, many studies involving men have been too small or lacked sufficient follow-up to provide comprehensive data on fracture rates. As a result, Medicare and many private insurers do not cover screening for men who have not already experienced a fracture, placing the onus on patients to request screenings.

The Importance of Early Detection and Treatment

Osteoporosis typically goes unnoticed until a fracture occurs, making early detection critical. Dr. Orwoll, an endocrinologist at Oregon Health and Science University, emphasizes that men should seek a DXA scan if they have experienced a fracture after age 50. Other risk factors include falls, a family history of hip fractures, and various health conditions such as rheumatoid arthritis and Parkinson’s disease. Lifestyle factors, including smoking and excessive alcohol consumption, also contribute to increased osteoporosis risk.

Upon diagnosis, treatment options vary based on the severity of the condition. Doctors may prescribe medications such as Fosamax or Actonel, along with lifestyle changes like exercise and dietary adjustments. While some guidelines do not yet universally recommend screening for all men over 70, there is a growing call for increased awareness and proactive measures regarding osteoporosis in men.

As life expectancy rises, more men are living into their 70s and 80s, making them susceptible to fractures that can lead to disability or decreased quality of life. Dr. Bauer advocates for screening, stating that men can experience significant improvements in both mortality and life quality with appropriate treatment.

Ultimately, raising awareness of osteoporosis among both men and health care professionals is crucial. While progress has been slow, it is necessary for patients like Klein to advocate for their bone health. Klein recalls attending a seminar about osteoporosis treatment, noting that he was the only male present. His experience underscores the urgent need for a shift in perception regarding osteoporosis as a health issue that affects all genders.