Osteoporosis in men overlooked by doctors and patients

  • Osteoporosis is a condition where bones weaken as people age, increasing the risk of bone fractures
  • It is less common in men than in women, but men experience a higher fatality rate from fractures requiring hospitalisation later in life
  • Researchers call for older men to be assessed regularly for the condition, especially those who have broken a bone previously
  • Osteoporosis affects over three million people in the UK, with over half a million needing hospital treatment for fractures due to fragile bones every year

Osteoporosis in men is often overlooked by health care professionals, a study in The Lancet Diabetes and Endocrinology from the University of Sheffield has found.

Researchers say raising awareness of the condition in men is desperately needed to help improve outcomes for patients.

Osteoporosis is a condition where the bones gradually weaken – a normal part of the ageing process, but some people lose bone density much faster than others, making their bones more fragile, and at risk of needing hospital treatment for fractures.

Women are generally at higher risk of developing the condition, as their bone density declines more rapidly than men at an earlier age, especially following the menopause. In most populations, men have larger and stronger bone and joint surfaces, so they can be overlooked when diagnosing the condition.

Researchers from the University of Sheffield reviewed available data on the condition in men, finding that they are generally diagnosed later, comply with treatment less and present to hospital in older ages than women. With fatality rates from hospitalisations with fragility fractures, like a broken hip, being higher than women.

Dr Tatiane Vilaca, author of the review from the University of Sheffield’s Department of Oncology and Metabolism said: “Generally diagnosis of osteoporosis happens when a patient presents at hospital with some kind of fragility fracture in older age, for example falling from standing height, and breaking a hip, wrist or spine.

“Research suggests men hospitalised with hip fractures tend to be older than women, which could be because the condition develops more slowly in men. As older people are usually slightly frailer, with poorer states of overall health, this could explain the slightly higher levels of disability and mortality associated in men with osteoporosis who are hospitalised following a fracture.”

Osteoporosis affects over three million people in the UK and more than 500,000 people receive hospital treatment for fragility fractures every year as a result of the condition.

Treatment for the condition is based on preventing broken bones through diet, exercise, and lifestyle changes, alongside taking medicine to strengthen bones.

The review found that although there is a lack of research about which treatment options are most effective in men, diagnosis and treatment options are effective.

The team believe further research specifically tailored to osteoporosis in male patients will help improve current diagnosis systems, helping clinicians with earlier diagnosis, and a focus on education for patients will support compliance with drug treatment programmes, all improving outcomes for men living with osteoporosis.

Dr Richard Eastell, Professor of Bone Metabolism at the Department of Oncology and Metabolism, said: “As women make up larger numbers of people living with osteoporosis, the data we have on the progression of the condition in men is currently not as robust. This updated review shows that further studies of male patients could help improve current diagnosis systems, as well as resources for the education of primary care clinicians and the general public on the early warning signs of osteoporosis in men.”

Dr Vilaca added: “Despite the current gap in knowledge, men can still easily be screened for osteoporosis at their GP surgery.

“Anyone with a family history of osteoporosis, broken bones, or fractures, those with acute back pain or a loss of height should be encouraged to have a check-up.

“These are all early warning signs of the condition in both men and women, and early preventative treatment is the best way to ensure a slower disease progression and longer, healthier life without a fracture.”

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