Men Aren't Being Screened--But They Get Osteoporosis, Too!
Most men don’t think of osteoporosis as their problem. Bone loss is still widely viewed as a women’s health issue. But the reality is very different.
About 1 in 5 men over age 50will suffer an osteoporotic fracture in their lifetime. And roughly25% of hip fractures occur in men.
When those fractures happen, the outcomes are often worset han in women: higher rates of disability, institutionalization, and death.
This statistic shocked me: a man over 50 is more likely to die from complications of a major osteoporotic fracture than from prostate cancer.
Thanks to their bigger, thicker bones, men tend to develop osteoporosis 5-10 years later than women do. In previous generations, life spans were shorter. Until recently, men died of heart disease and smoking before osteoporosis could harm them.
Now, men often live into their 70s and 80s. Fractures are becoming more common, frequently complicated by other chronic conditions typical of that age that make recovery slower and more difficult.
With osteoporosis testing and treatment, men could see improvements in mortality and,more importantly, quality of life.
Why aren’t more men being screened?
Part of the problem is awareness.
Osteoporosis is usually silent until a bone breaks. Unlike heart disease or diabetes, there are no early warning symptoms.
Another issue is inconsistent medical guidelines.
The Endocrine Society and the American Society for Bone and Mineral Research recommend that men 50 and older who have a risk factor, and all men over 70,should be screened.
But the American College of Physicians and the U.S. Preventive Services Task Force have deemed the evidence for screening of men “insufficient.”
As a result, many insurance plans don’t cover routine bone density scans for men unless they’ve already had a fracture.
That’s a dangerous gap.
In a recent study of older male veterans, only 2% had undergone bone density screening.
When a simple bone health program was introduced, complete with reminders and education, nearly half agreed to be tested.
Of those, 50% had osteoporosis or osteopenia, and most wanted to start treatment.
Risk factors for osteoporosis in men include:
Any fracture after age 50
Falls or balance issues
Family history of hip fractures
Smoking or heavy alcohol use
Certain medications (especially steroids and prostate cancer treatments)
Chronic conditions, such as rheumatoid arthritis, thyroid disease, or Parkinson’s
Lifestyle habits--strength training, adequate protein intake, calcium, and vitamin D--are important, but for many men, they’re not enough.
Should men get a bone density test?
If you have risk factors and want to know the status of your bones, a DEXA scan is a reasonable step, even if it means paying out of pocket (typically $150–$300).
It's noninvasive, totally painless, and takes just a few minutes.
Women typically get a baseline scan around age 50 and follow-up scans every two years to monitor changes in their bone status.
Men, on the other hand, often don’t discover they have osteoporosis until something breaks.
Two-thirds of older adults never regain their prior level of mobility after a hip fracture.
Waiting for osteoporosis to reveal itself with a fracture comes with consequences that are often irreversible.
