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OSTEOPOROSIS A 'SIGNIFICANT' PROBLEM FOR MEN KNOW THIS

January 27, 2008 12:16 am

By CAROLYN POIROT

McCLATCHY-TRIBUNE NEWS SERVICE

It's no wonder that most consumers and many doctors consider osteoporosis a "women's health" issue: More than 8 million women in this country suffer from it.

It's often termed "postmenopausal" osteoporosis, and for years the only medical treatment was female hormone replacement therapy.

But more than 2 million men have osteoporosis, too. And an additional 12 million have lower than normal bone density, or osteopenia, putting them at increased risk for osteoporosis.

"Osteoporosis is a significant problem in men and much less appreciated than it is in women," says Dr. Glenn Cunningham, an endocrinologist and professor of medicine at Baylor College of Medicine in Houston.

"Prevalence and fracture rates are not as great. However, when men have a hip fracture, it is really devastating. One-third are dead within a year."

Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, about 30 percent of them in men.

However, neither the National Osteoporosis Foundation nor the U.S. Preventive Health Services Task Force mentions men in its screening guidelines.

And most insurance, including Medicare, will pay for screening only in men who have already broken a hip, wrist or vertebra, or who are at particularly high risk because of certain other diseases or long-term use of certain medications.

Osteoporosis traditionally has not been something men worry about, perhaps because men traditionally haven't lived long enough to get it, said Dr. Edward Katz, a rheumatologist at the Arthritis and Pain Center in Fredericksburg.

The onset of osteoporosis typically happens later in men than in women for a few reasons. Men typically have a larger bone mass than women and therefore have a greater reserve when bone loss starts to accelerate, Katz said. Men also don't lose hormonal support until later in life, said Dr. Louis Levitt, an orthopedic surgeon in Washington.

But by age 65 or 70, men are losing bone mass as fast as women, says the NIH.

"Men are living longer now," Levitt said, "so diseases like osteoporosis are becoming more of a factor for them."

New drugs for treating osteoporosis have been developed in the past 15 years that, unlike estrogen supplements, work just as well for both sexes.

The condition was once treated primarily with calcium supplements and estrogen replacement therapy. But osteoporosis is now treated most often with drugs known as bisphosphonates, along with calcium and vitamin D.

-Becky Piedel contributed to this report.