ALTHOUGH osteoporosis (or brittle bone disease) is well known and lots are being constantly written in the popular press all the time, the female victims of the disorder are usually discussed. True the condition is more common in women, especially after the ‘change of life’ it must also be remembered that men are not totally immune to this. And as the health of men is receiving more attention perhaps one should look into this condition among men.

Just to kick off, of all the osteoporosis-related bone fractures, about a third occur in men and the life time risk of such fractures is in the range of 15 to 30 per cent among the over 50s.

In general men tend to sustain more bone injuries and fractures at a younger age mainly due to their work and activities – high-energy traumas at work, sports injuries and traffic accidents. But such incidents are the effects of trauma or impact with something else. In the later years the bone breaks are mainly due to fragility, minimal trauma or minor falls or even due to sharp body movements.

Sadly the condition in the men tends to remain under estimated, under diagnosed, and under treated. Many feel osteoporosis is a disorder affecting only elderly post menopausal women.

To be fair, male bones tend to be thicker, stronger and less prone to fractures in their younger and middle ages. The ‘fragility’ fractures are usually less common due to their greater bone density and thicker cortical mass. That said however, things do not remain the same in later years of life, from the third decade both cortical and trabecular bone loss set in making them prone to pains and fractures.

Curiously, it is ‘rudimentary’ existence of the female hormones that usually protect the bones from deterioration; just as in women, it is the oestrogen-related hormones are essential here too. Loss of muscle mass (sarcopenia) due to progressive loss of male hormones make men more prone to falls and traumatic fractures.

The main causes of male osteoporosis are smoking, excessive intake of alcohol, lack of regular exercise, low body mass index and poor dietary intakes of calcium and vitamin D.

The other procedures for osteoporosis have no gender differences. Subjects with suspected osteoporosis should be properly investigated by a no of blood tests and a bone scan (DXA) to measure the density of bones. In complicated cases further more sophisticated tests may be required.

As re management, the single most important measure is to remain active and to take regular measured exercise, to stop smoking and to reduce the intake of alcohol. Dietary intakes of calcium eg milk, cheese etc supplemented by tablets and vitamin D supplements. There are a variety of ‘drugs’ which are prescribed but the results are not usually quick. A slow process takes a long time to improve.

Many charities are deeply involved in educating people on how not to develop this terrible brittle bone disease and what to do if they do get it.

I sincerely hope they meet with success.

Arup Banerjee