Osteoporosis is not just a women's issue. Although it has traditionally been associated with the female population, more and more studies reveal a high incidence of this bone disease in men over 50 years of age, especially in those with low testosteroneMale osteoporosis is a silent but dangerous condition that can lead to serious fractures, hospitalizations, and even increased mortality if not detected early. In this article, from Doctor T Clinics, we explain what osteoporosis is, why it also affects men, its relationship with low testosterone, and how you can prevent or treat it with a specialized medical approach.
What is osteoporosis?
La osteoporosis It is a disease that causes the person who suffers from it to progressive weakening of the bones. As the name suggests (osteo, "bone" and porosis, "pore formation"), this disorder causes the space in the porous structure of the bones to grow through wear and tear, thus weakening the bones and possibly causing them to break. This happens because the bone structure does not regenerate.
The bodies of healthy men and women are responsible for making new bone that progressively replaces the old bone that wears down naturally. When the body is not able to replace bone at the same rate as it wears out, is when osteoporosis arrives.
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In 2010, in the European Union, more than five million people were diagnosed with osteoporosis. In Spain there are three and a half million men affected and it is estimated that There are many others who are at risk of suffering from it sometime.
According to the WHO, 1 in 5 men over 50 will suffer a bone fracture which will affect their quality of life and possibly cause premature death.
Diagnosis of osteoporosis in men
While this is a silent disease Since it does not present specific visible symptoms, it can be identified through medical tests.
To find out if the disease exists or if there is a risk of suffering from it, a blood test is usually performed. bone mineral density test (dual-energy X-ray absorptiometry), but can also be found out through a blood test; the calcium and vitamin D indicators are significant.
Early diagnosis can make a big difference, so it's important to pay attention to risk factors.
Factors riesgo
Some of those who are considered Risk factors for osteoporosis in men are:
- Be older than 60 years
- Being Caucasian
- Having family background osteoporosis
- Smoke
- Drinking alcohol in excess
- Do little or no exercise
- Carry one Diet low in calcium and vitamin D
- Having hypogonadism (testosterone deficiency). >>Find out more about the relationship between low testosterone and osteoporosis.<
- Regular use of steroid medications such as prednisone and cortisone
- Suffer any chronic diseases on the table:
- hyperthyroidism or other hormonal imbalances
- liver diseases
- some types of cancer
How do I know if I should have a bone density test?
It is essential to perform this test if:
- You present one or more of the risk factors
- Have you suffered any fracture (not due to accidents) after turning 50
- You notice that in recent years you have suffered a loss of height
Prevention and treatment of osteoporosis
There are some recommended practices that can be useful when it comes to preventing osteoporosis. For example:
- Do sports regularly. Especially advisable are those exercises in which we force the bones and muscles to support our own weight, such as when we run.
- No smoking.
- Limit the consumption of alcohol.
- Include sufficient amounts of calcium and vitamin D in the diet. These amounts vary with age so It is recommended that nutritional counseling from a professionall in this matter to ensure the correct intake of these vitamins and minerals.
Osteoporosis in men and its relationship with low testosterone
Did you know that in 50% of cases of osteoporosis in men, the cause is hypogonadism, excessive alcohol and glucocorticoids?
Far from being a minority, the number of people affected by osteoporosis is steadily increasing. It is estimated that the number of hip fractures in men will equal the number of hip fractures in women in 1990.
In Spain, more than 700 men are affected by osteoporosis, a percentage that is around 5% of the population.
In terms of likelihood, statistics suggest that one in five men over the age of 50 will suffer fractures due to osteoporosis. In some European countries, fractures in men are already a major cause of hospitalization.
Relationship between osteoporosis and low testosterone
There are a number of factors specific to men that increase the likelihood of suffering from osteoporosis. For example:
- surgical castration due to prostate cancer
- el male hypogonadism (inability of the testicles to produce sperm, testosterone, or both)
Did you know that a man's risk of suffering an osteoporotic fracture is greater than his chance of developing prostate cancer?
One in five men over the age of 5 will suffer an osteoporosis-related fracture in their lifetime.. These data highlight the Importance of early diagnosis also in man.
Knowing the risks is the first step to prevent and combat osteoporosis.
For reasons not established, the incidence of hip fractures in men has a tendency to increase more rapidly than in women. Mortality associated with hip fractures in men over 75 years of age is considerably higher than in women..
Bone mass is a predictor of mortality in men. Men with low testosterone (hypogonadism) have a mortality rate twice that of men with normal testosterone levels.
The differential diagnosis of osteoporosis in men includes the following:
Between 40 and 50% of all cases of osteoporosis in men are responsible for hypogonadism, excessive alcohol and glucocorticoids. Other causes to rule out are hyperparathyroidism, hyperthyroidism, multiple myeloma and idiopathic hypercalciuria.
Occult gastrointestinal disease should be taken into account, especially in the presence of low vitamin D levels, elevated parathyroid hormone levels, and low urinary calcium excretion.
Hypogonadism and osteoporosis
La testosterone deficiency It is a typical finding in 20 to 30% of men with vertebral fractures and more than 50% of men with hip fractures.
The most common age of these men is around 60 years old and they have had symptoms of impotence and excessive decrease in libido for 20-30 years. All the causes of primary hypogonadism o secondary hypogonadism may be associated with osteoporosis in men, including Klinefelter, hypogonadotropic hypogonadism, hyperprolactinemia, hemochromatosis, etc.
As for the more specific factors of osteoporosis in men, Any abnormal testosterone deficiency will have repercussionsIn fact, long-term testosterone deficiency has been shown to be typical in 30% of men with vertebral osteoporosis. Also, With less testosterone, there is less intestinal absorption of calcium, which leads to a decrease in bone formation..
Osteoporosis prevention
Osteoporosis in men remains underdiagnosed and undertreated, as does free testosterone deficiency. It is common for the latter condition to persist for more than 10 years before seeking medical attention. General preventive measures should be recommended, and when necessary, supplementation as well. Androgens are justified if hypogonadism is present, and if the risk of fracture is very high despite testosterone replacement, they should be associated with bisphosphonates.
Hormone replacement therapy also increases somatomedin levels. This has an important role in bone formation, as does DHEA: which is another androgen, which decreases with age.
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Conclusion
Osteoporosis in men is underdiagnosed, but that doesn't make it any less serious. One in five men over the age of 50 will suffer a fragility fracture at some point in their lives, and in many cases, the underlying cause is an untreated testosterone deficiency. Detecting it early and addressing its hormonal cause can make the difference between an active life or permanent dependence after a fracture.
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