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Osteoporosis: Men Get it, Too — Diagnosis Often Made After it is Too Late

(New York, NY. March 2003). A common misconception about a serious bone disease is causing needless pain and suffering in people who learn they are afflicted only after suffering a devastating injury. The disease, osteoporosis, makes bones fragile and more prone to break. Surveys have found that most people, including many health professionals, believe it only strikes women. But an estimated two million American men have osteoporosis, and three million more are at risk, according to the National Osteoporosis Foundation.

"Osteoporosis is an urgent health concern, particularly in men, because it is so often overlooked and undiagnosed in these patients," says Dr. Geoffrey Westrich, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan.

Dr. Westrich has seen the damage it can do. He has operated on numerous patients who have suffered broken bones because of osteoporosis-a disease they didn't know that had until they sustained a fracture, often in the hip, wrist, or shoulder. In seniors, a broken hip can be catastrophic, resulting in chronic pain and disability, loss of independence and even death. One-third of older patients who suffer a hip fracture don't survive more than a year, most often because of complications, such as pneumonia. One-half of older people who sustain a hip fracture end up in nursing homes.

"Many of these fractures and the tragic consequences could have been prevented if the disease had been identified and the patient had received proper treatment and made certain lifestyle changes," says Dr. Westrich.

The risk of osteoporosis increases with age. Like women, men can experience a marked loss of bone as they age, and the decline in bone mass is a major factor in the development of osteoporosis. By the time men reach 60, they have a 25 percent chance of sustaining a fracture caused by osteoporosis during the remaining years of their lives.

Osteoporosis affects fewer men than women because men have larger, stronger bones and do not experience the rapid bone loss that affects women when they reach menopause and their estrogen levels drop, according to Dr. Westrich.

But a number of factors put men at risk of developing the disease. The National Osteoporosis Foundation lists prolonged use of certain medications, such as steroids, some cancer treatments and aluminum-containing antacids; chronic diseases that affect the kidney, lungs, stomach and intestines, altering hormone levels; undiagnosed low levels of the hormone testosterone; certain behaviors, such as smoking, excessive alcohol use, low calcium intake and inadequate physical exercise; and heredity.

A fracture that occurs in the absence of a fall or other trauma is a warning sign of osteoporosis. Anyone who notices a loss of height, change in posture or sudden back pain should speak to his doctor, according to Dr. Westrich. He also advises patients with prominent risk factors to make sure their physician knows. Osteoporosis is diagnosed with a bone density test. A quick and painless type of x-ray, it provides information concerning bone strength and the risk of future fractures.

One medication -- Fosamax -- was approved last year to treat osteoporosis in men. The doctor may also recommend lifestyle and dietary changes. In addition, measures to prevent falls and subsequent fractures are critically important, according to Dr. Westrich.

"Anyone who has osteoporosis, or his family members, should ensure that his home is free of hazards such as slippery floors, rugs that are not secured and poorly lit areas," he warns. "Medications that cause the patient to be drowsy or disoriented should also be avoided."

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