No Bones About It: Osteoporosis Not Just Womanís Disease by Gina Shaw The news is in on Americaís bone healthóand itís not good. As a nation, weíre losing bone mass so rapidly that more than half of all people age 50 and over are already at risk for osteoporosis, and the numbers are climbing. According to a new report from the National Osteoporosis Foundation, 10 million people in the United States already have osteoporosis, and another 34 million are at risk. If current trends continue, by 2020 osteoporosis and low bone mass rates will jump by about 40 percent, with some 62 million people over age 50 either having the disease or at imminent risk for it. If youíre a man, youíve probably already stopped reading this article, or are about to. Osteoporosis is a ìwomanís issue,î right? Some 80 percent of osteoporosis patients are after all women. So why should you continue reading? Consider this: If 80 percent of people with osteoporosis are women, then 20 percent are men. Thatís 2 million men; another 12 million men have low bone mass. To put it in perspective, if youíre a man over 50, youíre at greater risk for osteoporosis-related fractures than you are for getting prostate ca ncer. In 2000, the Food and Drug Administration recognized the importance of the issue, approving the first osteoporosis drug, Fosamax, for men as well as women. Still not convinced that osteoporosis is a manís issue? After all, prostate cancer is a lot more serious than a fracture, and ìbones heal; chicks dig scars,î as the old rugby playersí slogan goes. Well, that might have been fine for a 20-year-old rugby player but not so for a husband and father coming up on his 50s. The National Osteoporosis Foundation reports that one in eight men over 50 will experience an osteoporosis-related fracture. Some 80 percent of hip fractures in Caucasian men 65 and older can be traced to osteoporosis. And just because the disease isnít cancer does not mean that it isnít deadly: Mortality in men one year after a hip fracture is nearly twice as high as it is for women. The cause of male osteoporosis is still a bit mysterious. In general, men are at lower risk for the disease than women are for a few main reasons: They have larger skeletons, their bone loss starts later in life and progresses more slowly, and they do not undergo the same rapid drop in bone density that affects women at menopause, when estrogen production plummets. However, Dr. Clifford J. Rosen, director of the Maine Center for Osteoporosis Research and Education and a leading researcher into male osteoporosis, has identified several factors that seem to put men at particular risk for bone loss and osteoporosis. Genetics plays a major role in male osteoporosis, as it does with many other diseases. If a manís mother or father had osteoporosis, then heís significantly more likely to have the disease than a male whose parents had no such history. Men with kidney stonesónot uncommon among older malesóalso appear to be at increased risk, and men who have experienced problems with their pituitary system or with the production of male hormones are at very high risk. Finally, men who have been treated with glucorticoids, such as cortisone or prednisone, for conditions including asthma, Crohnís disease and rheumatoid arthritis face a higher risk of developing osteoporosis. As women age, because of their own high risk for osteoporosis, bone density screening is often used to look for signs of bone loss. But thatís not yet practical for men because osteoporosis is less prevalent among men. However, if you are over 50 and have noticed unexplainable back pain, and you have one or more of the identified risk factors, itís a good idea to ask your doctor for a bone density test, even if he or she doesnít suggest one. Another warning sign: Do you feel, well, shorter lately? When you stand next to your wife, does the top of her head come up to your forehead now when before she only reached your chin? Loss of height in an adult male is a red flag for osteoporosis. ìMany people continue to assume height loss is a normal part of aging. However, it may be the first sign of vertebral fractures due to osteoporosis,î said Dr. Bess Dawson-Hughes, president of the National Osteoporosis Foundation. As for preventing osteoporosis, the advice is the same for men as it is for women: Donít smoke, limit your alcohol intake, and keep up a regular schedule of weight-bearing exercise, which is the kind of workout where your bones and muscles work against gravity, such as walking, jogging, racquet sports, stair climbing and team sports. Lifting weights or using resistance machines also appears to help preserve bone density. If you have already been diagnosed with osteoporosis, check with your doctor about what types of exercise are appropriate. Some kinds of twisting movements and high-impact exercise may not be a good idea if your condition is too severe. Of course, you should also be eating a nutritionally balanced diet that includes lots of calcium. About 40 percent of men over age 50 do not get the recommended daily allowance of calcium; you need 1,000 milligrams per day up until age 50, and after age 50 you need 1,200 milligrams per day. The National Osteoporosis Foundation offers support groups for people with osteoporosis, including one specifically aimed at men. For more information, please call (202) 223-2226 or visit www.nof.org/patientinfo/support_groups.htm. Gina Shaw is the medical writer for The Washington Diplomat.