Throughout its development, men have larger bones than women, reach a higher bone capital, that is to say, a “peak of bone mass” and they do not have the abrupt fall of their hormones as it happens in the female menopause. These conditions delay bone loss, but it does not mean that they cannot suffer it.
For several years now, it has been recognized that osteoporosis in men represents a major public health problem due to the presence of hip and vertebral fractures, although in a smaller number than the women.
“When the origin of the male osteoporosis, it is found that between 50 and 60% have a predisposing condition or disease. The most frequent are the hypogonadism (decrease in testosterone), treatment with corticosteroids, excessive alcohol consumption, gastrointestinal diseases, malignant diseases or prolonged immobilization ”, stated the doctor Alicia Bagur, osteologist physician, Medical Director of Mautalen Salud e Investigación.
For the specialist, one in 5 men over the age of 50 will suffer an osteoporotic fracture in his lifetime. “In Argentina, there is an annual average of 34 thousand hip fractures per year in people over 50 years of age; that is, 90 per day, with an approximate ratio of 3 women to each man. Values that will double by 2050 ”, he added.
“Osteoporosis affects both men and women because it is a product of aging. It is recommended to do a bone mass measurement, a densitometría, what is the way to detect if there is osteoporosis in men older than 70 years, regardless of whether they have another risk factor for suffering from it, ”explained Dr. Diana González (MN 55307), an osteologist.
In this sense, he pointed out that a risk factor is those who have hypogonadism (decreased testosterone production), those who are subjected to corticosteroid or anticonvulsant treatments, when there is alcohol abuse or gastrointestinal disorders or diseases, or when there is a history of a fragility fracture, densitometry may be considered before age 70, even after age 50.
“A man who suffers a vertebral fracture for lowering the gate of his house or for lifting a suitcase, that is a fragility fracture, he surely has osteoporosis and must undergo a densitometry to evaluate the type of treatment and follow up”, added González .
According to Dr. Bagur, this disease can be prevented by correcting, as far as possible, bone risk factors, doing physical activity that includes resistance exercises and lifting moderate weights, on a regular basis.
“This improves bone and muscle, preventing falls that cause fractures. Also important is consumption of foods rich in calcium (1000 to 1200 milligrams per day), vitamin D by solar blast for 15-20 minutes in the morning or afternoon. If it is contraindicated due to skin problems, vitamin D supplements and reducing tobacco and alcohol are indicated ”, he clarified.
Hypogonadism is common in 30% of men who have vertebral fractures. It is also related to a decrease in vitamin D synthesis and lower absorption of calcium provided by food. In older men, hip fractures are added.
The osteologist Beatriz Oliveri (MN 55648), from the Hospital de Clínicas, pointed out that men suffer from osteoporosis and it is generally not a topic they consult. “LMen have a higher percentage of death and morbidity after hip fracture. Mortality the year after the hip fracture is higher in men than in women “, dijo Oliveri.
Added that Over time, men also lose bone mass, they are decalcified a little later than women, around 60/65 years. “About half of the men with osteoporosis have a secondary cause of the disease,” he noted.
With respect to the causes of hypogonadism highlighted that “one of them, which is sometimes not taken into account for preventive treatment, are those men who have prostate cancer and therefore receive specific medication, to decrease their male hormones and they have a significant increase in fractures, a very high percentage of osteoporosis and sometimes they are not given the proper treatment “. And he added: “men must be studied whenever they have an osteoporotic fracture because the possibility of later fractures increases, even in the year after it,” added Oliveri.
“Treatment with active drugs for osteoporosis is evaluated by the doctor according to the history of each patient. In the first place, if there is a disease that causes it, the initial objective will be to treat it. Osteoporosis drugs that stop bone loss or stimulate bone formation reduce the incidence of fractures by 40 to 70%”, Concluded Bagur.
Like women, men suffer from osteoporosis and must be studied and treated to avoid hip and vertebral fractures and their subsequent complications.