Osteoporosis: Not Just For Women

Daniel Holland, PharmD
Published Online: Tuesday, August 2nd, 2016
Health care providers often overlook osteoporosis screening in an important group: men. This tendency may occur because public health officials have placed a heavy emphasis on osteoporosis prevention in women.

Two million men in the United States have osteoporosis and 12 million have osteopenia (lowered bone density). Men constitute 30% of osteoporosis patients and experience worse outcomes post-fracture than women. In fact, the 80,000 American men who experience a hip fracture every year are 50% more likely to die in the 12 months following fracture than women.

The expansion of regular screening in all care settings can improve this population’s quality of life and risk of fracture. Although the US Preventive Services Task Force doesn’t recommend screening men routinely, health care professionals can still deliver crucial osteoporosis screening to this underdiagnosed and undertreated population.

Clinicians can communicate to both men and women that causes of osteoporosis may include:

·      Traumatic fracture history
·      Family history
·      Level of physical activity
·      Menopause
·      Prolonged steroid use
·      Excessive daily alcohol use
·      Smoking
·      Chronic liver or kidney disease
·      Type 1 or type 2 diabetes mellitus
·      Human immunodeficiency virus infection
·      Antiepileptic drugs, including phenytoin, carbamazepine, primidone, and valproic acid

To mitigate these causes, clinicians should offer the following preventive recommendations to patients, especially older patients, in their clinic:

·      Get at least 30 minutes of exercise each day. Ideally, exercise should incorporate strength training.
·      Get a sufficient amount of calcium each day through diet or supplements.
·      Get a sufficient amount of vitamin D each day. This can be achieved either through 10 minutes of daily sun exposure or through diet. 
·      Reduce soda intake.
·      Stop smoking. Studies have suggested that smoking cigarettes can double the odds of bone loss and fracture.

Finally, clinicians can counsel their patients to go get a bone density test to evaluate the strength of their bones and their potential risk for osteoporosis.

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