How Is Osteoporosis Diagnosed In Men?
Osteoporosis can be effectively treated if it is detected before significant bone loss has occurred. A medical work-up to diagnose osteoporosis will include:
- a complete medical history
- x-rays
- urine and blood tests
The doctor may also order a BMD test or bone mass measurement. A special type of x-ray, the BMD test requires trace amounts of radiation. It is safe, accurate, quick, painless, and noninvasive and can be used to detect low bone density, predict risk for future fractures, diagnose osteoporosis and monitor the effectiveness of treatments.
It is increasingly common for women to be diagnosed with osteoporosis or low bone mass using a BMD test, often at mid-life when doctors begin to watch for signs of bone loss. In men, however, the diagnosis is often not made until the patient sees his doctor complaining of back pain or until a fracture occurs. This makes it especially important for men to inform their doctor about:
- risk factors for developing osteoporosis
- loss of height
- change in posture
- a fracture
- sudden back pain
Some doctors may be unsure how to interpret the results of a BMD test in male patients. For example, it is not known whether the guidelines used to diagnose osteoporosis or low bone mass in women (developed by the World Health Organization) are also appropriate for men. Until that question is answered--and until separate criteria are established for men, if necessary--most experts suggest using the WHO criteria for men.
What Treatments Are Available?
Once a man has been diagnosed with osteoporosis, his doctor may prescribe one of the medications approved by the Food and Drug Administration (FDA) for this disease.
The treatment plan will also likely include other nutrition, exercise, and lifestyle guidelines for preventing bone loss.
If bone loss is due to glucocorticoid use, the doctor may prescribe a bisphosphonate, monitor bone density and testosterone levels and may suggest using the minimal effective dose of glucocorticoid, discontinuing the drug when practical, and/or topical (skin) administration.
Other possible prevention or treatment approaches include:
If osteoporosis is the result of another condition (such as testosterone deficiency) or exposure to certain medications, the doctor may design a treatment plan to address the underlying cause.
Recommendations for Calcium and Vitamin D Intake in Men
How Can Osteoporosis Be Prevented in Men?
There have been fewer research studies on osteoporosis in men than in women. However, experts agree that all people should take the following steps to preserve their bone health.
- Avoid smoking.
- Reduce alcohol intake.
- Increase levels of physical activity.
- Ensure a daily calcium intake that is adequate for your age.
- Discuss with the doctor the use of medications, such as corticosteroids, that are known to cause bone loss.
- Recognize and treat any underlying medical conditions that affect bone health.
- Ensure an adequate vitamin D intake. (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 at least 400 IU but not more than 800 IU/day; 400 IU is the amount found in one quart of fortified milk and most multivitamins.)
- Engage in a regular regimen of weight-bearing exercises where bones and muscles work against gravity.
- walking
- jogging
- racquet sports
- stair climbing
- team sports
- lifting weights
- using resistance machines
Weight-bearing exercise includes:
A doctor should evaluate the exercise program of anyone already diagnosed with osteoporosis or arthritis to determine if twisting motions and impact activities, such as those used in golf, tennis, or basketball, need to be curtailed.
Related Resources
Source: Osteoporosis in Men, NIH Osteoporosis and Related Bone Diseases ~ National Resource Center, Rev Date: 1/2003
