Osteoporosis in men: a growing concern

Osteoporosis affects more men than women. Picture: Supplied

Osteoporosis affects more men than women. Picture: Supplied

Published 5h ago

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The National Osteoporosis Foundation (NOFSA) has revealed startling statistics that one in five men is at risk of a fracture from osteoporosis compared to one in three women.

According to the Bone Health and Osteoporosis Foundation, osteoporosis is a bone disease that causes the bones to become weak and brittle, making them more likely to break from a fall or, in serious cases, from sneezing or minor bumps.

Yolandé Venter, who is a dietitian, described a healthy bone viewed under a microscope as a honeycomb.

“Osteoporosis, put simply: is when the ‘holes and spaces’ in the honeycomb increase in size,” said Venter.

Often called an “old women’s disease”, ironically osteoporosis affects more men as compared to women.

The disease is asymptomatic, wherein bones become so fragile that a simple sneeze or small stumble results in a fracture, commonly in the hips, spine and wrists.

“Even though fewer men seem to be at risk of developing osteoporosis, it is still a problematic percentage. If you are underweight, it increases the risk of osteoporosis and if you are overweight, your level of vitamin D is reduced, which can cause or worsen osteoporosis,” said Venter.

Dr Jaco du Plessis, a radiologist at SCP Radiology, explained that bone mineral density (BMD) can be tested through a diagnostic radiology exam that measures bone mineral content and mass.

The procedure is performed with an X-Ray machine called a DEXA scan, which is commonly found in medical facilities, or with a computed tomography (CT) scan of the bones.

“A computer tomography (CT) scan produces a 3D image, as opposed to the normal 2D image of a DEXA.

“The CT scan is more precise and gives detailed information about bone quality and microarchitecture, diagnoses osteoporosis and other conditions.

“However, the DEXA uses a low radiation exposure making it safe for routine screening and follow-up. The amount of radiation is minimal, it’s equivalent to one or two days of background radiation at sea level,” said du Plessis.

SCP Radiology reported that there had been a 317% increase in referrals for men for a CT scan over the last five years, which may indicate that men are more prone to osteoporosis.

“Understanding and managing both conditions is crucial for maintaining bone health and preventing fractures in both men and women,” said Du Plessis.

Du Plessis noted that low bone density is caused by age, genetics, ethnicity and medical conditions associated with bone loss.

Other risk factors include the abuse of tobacco and alcohol, a high intake of caffeine, poor dietary habits, low calcium and Vitamin D intake, and low muscle mass.

He also said men who are on treatment for breast and prostate cancer pose a risk of osteoporosis – they should conduct regular bone health screening.

While women experience menopause as they age, men develop andropause.

Du Plessis mentioned that men tend to lose bone density in the spine four times greater than in the rest of the body during andropause.

“Andropause also lowers testosterone levels, which affects bone health and increases the risk of bone fractures,” said Du Plessis.

Venter highlighted that the one-year mortality rate after hip fracture is high, and more men than women die after an osteoporotic fracture.

“Looking at the statistics, it is clear that osteoporosis represents a major public health burden, yet it does not seem that wider screening efforts are being implemented.

“Literature clearly demonstrates that prevention and treatment of osteoporosis significantly reduces fracture risk.

“An observational study by Kern et al. (2005) showed that hip DEXA screening was associated with a 36% lower hip fracture incidence during six years of follow-up, compared with standard medical care,” said Venter.

The Star

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