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Illness prevention and treatment

March 05, 2013

Men get osteoporosis, too

20% of men will break a bone due to osteoporosis in their lifetime. Yet 95% of them don’t know they have osteoporosis.

Men osteoporosis

It took eight fractures before Larry Funnell’s osteoporosis was diagnosed -- at age 48. Once it was a minor slip on a stair leading to a broken wrist. Another time it was a “little fall” on a golf course that broke his upper arm.

But no alarm bells went off for almost a decade, even though Funnell had a family history of the condition. “I was one of those men who kept falling through the cracks,” says Funnell, a retired civil servant living in Cloverdale, B.C. “Not once did any health professionals think to ask me about my bone health.”

Finally, in 1998, Funnell was diagnosed after being referred to an initially skeptical male family doctor by his wife’s physician, a woman used to seeing post-menopausal women with the condition. Funnell remembers thinking: “How can I have osteoporosis? That’s something frail older women get.”

Men are unaware of the risk of osteoporosis

20% of men will break a bone due to osteoporosis in their lifetime, according to Osteoporosis Canada. And 37% of men who  break a hip will die within a year.

Yet 95% of them don’t know they have osteoporosis, says the Public Health Agency of Canada. Symptoms may include:

  • Frequent fractures, often after seemingly innocuous falls.
  • Losing a considerable amount of height.
  • A change in posture, such as becoming hunched over.
  • Back pain.

Or, you could have no symptoms at all.

Risk factors for osteoporosis include:

  • Steroid use (such as inhaled asthma medications or prednisone for skin conditions) for three months or longer.
  • Prostate cancer treatment.
  • A family history of osteoporosis.
  • Long-term low milk consumption due to dairy allergy or lactose intolerance.

Even if risk factors are present, men are often unwilling to seek a diagnosis, says Funnell, who now chairs the Canadian Osteoporosis Patient Network. He admits there’s a stigma among men, who wrongly feel that having brittle bones makes them less male. “I hid the news of my diagnosis from all but my family and closest friends,” he says.

Dr. Bill Leslie, chair of the Scientific Advisory Council, Osteoporosis Canada (SAC) in Winnipeg, says men's diagnoses of osteoporosis are often delayed, even after a fracture occurs. This could be due to a communication breakdown between the hospital where the fracture is initially treated and the family doctor's office, the failure of the family doctor to think of osteoporosis, or a patient's wish to put the fracture behind him as quickly as possible.

“Requesting a bone density test may be overlooked by busy GPs who must follow numerous practice guidelines,” says Leslie. “And patients don't always make the connection -- many are happy to blame the fracture on that patch of ice.”

He says the SAC has launched a campaign to raise awareness of osteoporosis: “Make the first break the last!” Aimed at patients, family doctors and government, it hopes to make osteoporosis the first thing that springs to mind when a patient shows up with a broken bone after a minor fall. “We are making progress, but we still have a long way to go,” he says.

Stop osteoporosis in its tracks

Preventing osteoporosis is possible, even if you’re at higher risk. If you suspect you may have the condition, talk to your doctor about a bone mineral density test, which can assess if and how much bone loss you have.

If you’re diagnosed with bone loss, a condition called osteopenia, take these steps to prevent it from developing into osteoporosis:

  1. Perform weight-bearing exercises regularly to help maintain bone and muscle strength and to avoid falls, says Leslie. The type of exercise depends on your fitness level but can include walking, tai chi, jogging, dancing or stair-climbing.
  2. Talk to your doctor about calcium supplementation. Osteoporosis Canada recommends 1,000 mg daily for adults aged 19 to 50, and 1,200 mg per day for those over 50.
  3. If you’re diagnosed with osteoporosis or osteopenia, talk to your family doctor about medications that can reduce bone loss or even build bone. These include bisphosphonates and biologic medications made from a form of parathyroid hormone.

Three ways to keep ahead of osteoporosis

  • View a fracture after a minor slip as a red flag and push your doctor to investigate.
  • Make sure your diet includes enough calcium, vitamin D and protein.
  • Quit smoking, curb coffee and cut back on alcohol to reduce bone loss

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