By Julie Sevrens Lyons
Mercury News
Elderly women with painfully bent backs have long been the symbol of
osteoporosis, the brittle bone disease that can cause devastating fractures. But
now researchers are warning another group is at much higher risk for the
condition than previously thought: Men, of all ethnicities, even as young as 50.
A major new study of more than 600 Northern California men has found
one-third have osteoporosis, but few had previously been screened for it or
received treatment.
``This is really a silent problem,'' said Dr. Arthur Swislocki, lead author
of the study, which will be presented at an endocrinology conference in San
Francisco on Friday. ``Men's health seems to focus on the prostate, blood
pressure and cholesterol -- issues other than bones.''
Indeed, up until a few years ago, there were no bone-strengthening
medications approved for men. Osteoporosis research all but ignored men.
Educational brochures on the disease tended to be directed toward postmenopausal
women, focusing primarily on the importance of estrogen.
``But more men are likely to develop a hip fracture than to suffer prostate
cancer. That's something a lot of people don't realize,'' said Lynn Chard-Petrinjak,
a representative of the National Osteoporosis Foundation in Washington, D.C.
``There is a misconception that it's a female disease.''
An estimated 2 million men have osteoporosis, making up 20 percent of all
cases, according to the foundation. But many experts believe the number is
probably much higher, because most men are never screened for the disease, and
few make the effort to discuss symptoms with their doctor.
``It's a rising problem and it's an under-recognized problem,'' said Dr.
Elliott Schwartz, co-medical director of the Foundation for Osteoporosis
Research & Education in Oakland.
Scientists aren't sure why osteoporosis rates are so high in men. In women,
the course of the disease is better understood -- women tend to experience rapid
bone loss after menopause, when hormone levels drop. That decline makes bones
brittle, and they fracture more easily.
But men don't experience such a quick decline in hormone levels. As for
obvious risk factors that would explain why some men have osteoporosis and
others don't, ``so far we haven't been able to find any,'' Swislocki said.
Scientists hope to learn more about how testosterone levels, bone density,
smoking, alcohol and other factors may predispose men to the disease from an
ambitious long-term National Institutes of Health study of more than 6,000
American men.
``We don't know how men differ from women in many of these regards,'' said
Dr. Eric Orwoll, the study's lead investigator. ``But it's going to be quite a
while before we know all the answers.''
The two genders do have some attributes in common. By age 65 or 70, men and
women tend to lose bone mass at the same rate. The body's ability to absorb
calcium, an essential nutrient for bone health, also declines for both sexes
later in life.
The risk for osteoporosis among men clearly rises with advancing age, Orwoll
said. But age can't be unilaterally blamed, Swislocki's team found.
``It's not necessarily a disease of old men. It's potentially a disease of middle-aged
men,'' said Swislocki, whose team has found the disease in men in their early
50s. The patients studied are from throughout the northern part of the state but
were all originally seen at the Veterans Affairs Northern California Health Care
System in Martinez for problems unrelated to osteoporosis.
Women are still most affected by the disease, with half of all women older
than 50 suffering an osteoporosis-related fracture. But the new research
suggests a public health crisis could be emerging among men as more Baby Boomers
hit middle age.
Although women are encouraged to undergo periodic bone density exams, men
usually aren't diagnosed with the disease until they have gone to their doctor
complaining of back pain or bone fractures. By then, their osteoporosis is often
advanced and not as likely to respond to treatment.
``I just thought it was regular arthritis,'' said Margerito Perez, 76, an
Antioch resident who was diagnosed with osteoporosis four years ago. Perez, a
retired forklift operator who participated in the new study, said his back had
been hurting him for years before he went to a doctor.
Sure, he'd heard of osteoporosis before, and how older women are at high risk
for the disease.
``But I've never heard men talk about it,'' he said.
The disease needs to be taken more seriously by men because they can suffer
more serious side effects, Chard-Petrinjak said. Men have a higher mortality
rate following hip fractures than women, even though women suffer more
fractures.
That's news to most men, said Jerry Donnelly, editor of an online newsletter
for men with the disease. Donnelly was diagnosed eight years ago, at age 51.
``Several men have been point-blank told by their physicians that men don't
get osteoporosis,'' he said. ``So you generally get the reaction from men that,
`Wow, I didn't know I could have this.' ''
For more information on Men's Hormone Testing, click on link below
Male Hormone Profile
Bone Density Testing
Schedule and Locations
