Osteoporosis in men
Those who thought that osteoporosis is just a woman’s disease, will be disabused. 20 to 30 percent of patients with osteoporotic fractures are in men. Scientists assume: The number of affected men is expected to increase in the future due to the increasing life expectancy and the changed way of life. For men, there is still no clearly-documented risk characteristics.
But it is likely that the factors that can lead to osteoporosis, differ very little from those that can also trigger in women osteoporosis.
Strong risk factors are:
- Frequent Fall or Falls (within 6 months two or more times).
- Past or current history of bone fractures, which occurred from slight occasion
- Suspected vertebral fracture, for example, due to acute encountered persistent severe back pain or body height loss of 4 cm
- Under weight (Body mass index less than 20), or accidental loss of more than 10 percent of initial body weight
- Medications or other diseases that can lead to osteoporosis:
- About 6 months of continuous taking daily 7.5 mg of prednisolone or more (or equally-acting cortisone preparation), in particular in inflammatory rheumatic diseases
- Chronic inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
- Disturbances of the intake of food in the digestive tract (malabsorption syndrome: back lying on stomach removal, Sprue)
- Alcoholism, previous organ transplantation
- Hyperfunction of the parathyroid gland or of the thyroid gland
- Diabetes mellitus type I, heavily damaged kidney function
- Anemia due to Vitamin B12 deficiency
- Taking medications, for example Phenytoin for epilepsy
Weaker risk factors are:
- Family history (relatives with osteoporosis, back, forearm, vertebral body and femoral neck fracture)
- Inflammatory-rheumatic diseases
- Calcium / Vitamin D Deficiency
- Heavy Smoking (more than 20 cigarettes a day)
- Lack of exercise, especially in the case of immobilisation, physical disability
- Lack of testosterone (male sex hormone): A special role for the male hormone testosterone plays. It promotes the natural muscle and bone structure and contributes to the skeletal system remains resilient. Testosterone is not the man, comes within a few weeks to bone loss (osteoporosis).
To testosterone deficiency:
- After viral illness (e.g. Mumps), the the testicles so damaging, that only low testosterone quantities to be produced
- In the case of functional disorders of the pituitary gland
- After removal of the testes (for example, prostate cancer)
- Decreasing testosterone production in old age
Osteoporosis evaluation in men
As in the case of women, it must also be in men, a careful Risk assessment and investigation of the cause. In case of need, will be determined in men in addition, the testosterone content in the blood. Often, a bone sample (biopsy) is useful in men.
Treatment of osteoporosis sick men
As a “basic therapy” are the adequate administration of Calcium / Vitamin D as well as muscle training and fall prevention in addition to hormone or bone stabilizing set of drugs is essential. For the treatment of osteoporosis in men the highly effective, bone stabilizing bisphosphonates are approved for Alendronate and risedronate.
Testosterone deficiency in the pathogenesis of osteoporosis is involved, can be considered (in addition to) a sex hormone put the end of therapy. This the physician needs to discuss with the person Concerned and, if necessary, also with the life partner in detail. In scientific studies it has been shown that the bisphosphonate Alendronate is also used in men with a testosterone deficiency was involved in the development of osteoporosis. In the case of Alendronate, the duration of treatment is usually two to three years.