“Men get osteoporosis, and when men sustain the fractures from this disease, they may suffer more from the devastating consequences.” ~ Dr Abelson

Most people associate the disease of osteoporosis with women – post-menopausal women to be precise. However, as humans are living longer due to medical advancements, men are reaching older ages and also experiencing symptoms of this silent disease. The misconception that osteoporosis is a “women’s disease” likely stems from the fact that women are at risk earlier in life, even as early as their 50s – yet today men over 70 are equally at risk.

Osteoporosis is a disease that causes the skeleton to weaken and the bones to break. It is mostly associated with age, and longer lifespans actually present significant threat to millions of people worldwide. But because men don’t believe they are as susceptible as women to the disease as they age, they tend to not recognise the risks to their mobility and independence.

Looking at osteoporosis from a practical point, we find some home truths that all persons over the age of sixty should consider seriously.

  • Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs.
  • It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss. However, the number of men above the age of 70 who develop osteoporosis continues to increase as human life expectancy continues to rise.
  • Bone is constantly changing as old bone is removed and replaced by new bone. During childhood, more bone is produced than removed, so the skeleton grows in both size and strength. For most people, bone mass peaks during the thirties. By this age, men typically have accumulated more bone mass than women. After this point, the amount of bone in the skeleton begins to decline slowly as removal of old bone exceeds the formation of new bone.
  • Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Perhaps because such fractures tend to occur at older ages in men than in women, men who sustain hip fractures are more likely than women to die from complications.
  • The majority of men with osteoporosis have at least one secondary cause, such as: medication, low levels of testosterone, alcohol abuse, smoking, gastrointestinal disease and immobilisation.

Major differences between male and female bone development

  • One of the most significant differences between male and female skeletons is body size and bone size. These differences become evident at birth and continue throughout childhood.
  • Bone growth patterns in puberty in boys are different than in girls. Boys have two or more years of growth before puberty and a growth spurt that will last about four years, whereas girls have a growth spurt period of three years.
  • Peak bone mass differences in boys and girls are mostly determined by genetics. But they can also be influenced by factors such as regular exercise and diet, including regular consumption of dairy products, which are a natural source of calcium and Vitamin D – two nutrients vital to bone health.
  • By the early 20s, both genders achieve peak bone mass—that is the greatest amount of bone a person can attain.
  • It has been determined that even a 10% increase in peak bone mass would delay osteoporosis by 13 years. Peak bone mass achieved in adolescence is the single most important factor for preventing osteoporosis later in life.
  • Another consideration of bone growth in boys is testosterone – the major sex hormone in males – that helps to improve bone size. On the other hand, estrogen, the major sex hormone in females – reduces bone growth while regulating levels of bone mineral.
  • Differences in testosterone and estrogen offer rationale as to why boys develop larger bones and have higher peak bone mass than do girls. And this fundamental difference is also why adult women have a higher risk of fractures due to hormones rather than sports injuries or risk-taking.

The dangers of the aging process for both men and women

  • For men, bone loss starts later and progresses more slowly. While men in their 50s do not go through the rapid loss of bone mass that women have in the years following menopause, the rates of bone loss are the same by ages 65 or 70.
  • A bone density test is recommended for men over age 70 and even after the age of 50 if risk factors for low bone mass present.
  • Once bone is lost, the body can’t replace it with just calcium and Vitamin D. Excessive bone loss causes bones to become fragile and more likely to fracture, commonly in the hip, spine, and wrists – and can be permanently disabling.
  • Men who sustain hip fractures are more likely to die from complications than women. More than half of all men who suffer a hip fracture may remain living in nursing homes or intermediate care facilities for the rest of their lives.

However, taking cognisance of all these factors well in advance of old age, is hugely helpful. Aspects to be aware of include: an awareness of family history; Vitamin D deficiency; smoking, excessive drinking, low calcium intake, and a sedentary lifestyle. Get a healthy diet and lifestyle plan into your life and understand that maintaining robust bones in younger years will determine the structure of your life in later years.

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za