Osteoporosis in Men Osteoporosis in Men
National Institutes of Health

Osteoporosis is a disease that causes the skeleton to weaken and the bones to break…Bone are constantly changing—that is 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 third decade of life. By this age, men typically have accumulated more bone mass than women. After this point, the amount of bone in the skeleton typically begins to decline slowly as removal of old bone exceeds formation of new bone.

Men in their 50’s do not experience the rapid bone loss that women do. By age 65 or 70, however, men and women are losing bone mass at the same rate, and absorption of calcium, an essential nutrient for bone health throughout life, decreases in both sexes. After age 50, 6 percent of all men will experience a hip fracture and 5 percent will have a vertebral fracture as a result of osteoporosis.

There are 2 main types of osteoporosis: primary and secondary. In case of primary osteoporosis, either the condition is caused by age-related bone loss (sometimes called senile osteoporosis) or in the cause is unknown (idiopathic osteoporosis). The term idiopathic osteoporosis is used only for men less than 70 years old: in older men, age-related bone loss is assumed to be the cause.

The majority of men with osteoporosis have at least one (sometimes more than one) secondary cause. In cases of secondary osteoporosis, the loss of bone mass is caused by certain lifestyle behaviors, disease or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications, hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria, and immobilization.

There have been fewer research studies in men on osteoporosis than in women. However, experts agree that all people should take the following steps to preserve their bone health:

– Avoid smoking, reduce alcohol intake, and increase your level of physical activity.
– Ensure a daily calcium intake that is adequate for your age
– Ensure an adequate intake of vitamin D. Normally, the body makes enough vitamin D from exposure to as little as 10 minutes of sunlight a day. If exposure to sunlight is inadequate, dietary vitamin D intake should be between 200 and 600IU (International Units) per day (See Table below)
– Engage in a regular regimen of weight-bearing exercises in which bones and muscles work against gravity. This might include walking, jogging, racquet sports, stair climbing, team sports, lifting weights and using resistance machines. A doctor should evaluate the exercise program of anyone already diagnosed with osteoporosis.
– Discuss with your doctor the use of medications that are known to cause bone loss, such as glucocorticoids.

The following recommendations for calcium and vitamin D intake are given by the National Academy of Sciences in 1997.

AGE CALCIUM (mg) Vitamin D (IU)

19-30 1,000 200
31-50 1,000 200
51-70 1,200 400
70+ 1,200 600

UPPER LIMIT 2,500 2,000

RESOURCE

For additional information on osteoporosis, visit the National Institutes of Health Osteoporosis and Related Bone Diseases—National Resource Center web site at www.niams.nih.gov/bone or call 1-800-624-2663