But more than 2 million men have osteoporosis, too. And an additional 12 million have lower than normal bone density or "osteopenia," putting them at increased risk for osteoporosis.

"Osteoporosis is a significant problem in men and much less appreciated than it is in women," says Dr. Glenn Cunningham, an endocrinologist and professor of medicine at Baylor College of Medicine in Houston. "Prevalence and fracture rates are not as great. However, when men have a hip fracture, it is really devastating. One-third are dead within a year."

Here are three essential things everyone should know about this condition in which bones become abnormally porous and fragile so that they break easily.

1. Risk Factors
Risk factors include some you have no control over and some you do, such as:

• Female gender: Women in general have lighter, thinner bones than men, so osteoporosis is more common. At age 35, the average woman has 30 percent less bone mass than a man of the same age.

• Skeleton size: Men and women with small bones are at higher risk.

• Aging: After increasing bone mass until about the age of 35, men and women then begin to lose bone mass. When a woman reaches menopause at about age 50, the loss is much more dramatic because she produces much less estrogen, a female hormone that helps maintain bone mass.

• Heredity: A parent or grandparent with osteoporosis puts you more at risk.

• Smoking

• Excessive alcohol

• Low calcium intake throughout life

• Inadequate exercise

• Medications: Long-term use of steroids to treat asthma and arthritis, anticonvulsants, some cancer treatments and aluminum-containing antacids contribute to bone loss.

Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, about 30 percent of them in men. However, neither the National Osteoporosis Foundation nor the U.S. Preventive Health Services Task Force mentions men in its screening guidelines. Most insurance, including Medicare, will pay only for screening in men who already have broken a hip, wrist or spinal vertebrae or who are at particularly high risk because of other diseases or long-term use of certain medications.

Screening is recommended for all women older than 65 and postmenopausal women younger than 65 who have one or more risk factors as well as older men and women who suffer a fracture.

Screening is quick, painless and inexpensive. The standard technique for determining bone density is a low-dose X-ray called DXA "dual X-ray absorptiometry," which takes less than five minutes. This test most often involves a hip and spine scan.

There also are less-definitive wrist screening tests, which are sometimes available free at health fairs.

3. Treatment Options
New drugs have been developed in the past 15 years that, unlike estrogen supplements, work just as well for both sexes.

Once treated primarily with calcium supplements and estrogen replacement therapy, osteoporosis now is treated most often with bisphosphonates, calcium and vitamin D.

Bisphosphonates basically put a brake on the bone-breakdown process, says Dr. Kurt Kennel, an assistant professor of medicine at the Mayo Clinic. They include Reclast, the first and only once-a-year treatment for osteoporosis, which was approved by the FDA in late August. An IV infusion, Reclast treatment takes just 15 minutes in a doctor's office. Other bisphosphonates include Fosamax and Actonel, tablets taken once a week; and Boniva, a newly approved tablet taken once a month or by injection every three months.

The other class of drugs for treating osteoporosis is designed to rebuild bone. Those drugs include Forteo, a parathyroid hormone, given by injection; Calcitonin, a hormone that helps regulate calcium levels in the body, given by nasal spray or injection, and Raloxifene (Evista), an estrogen modulator.

The decision on which drug to prescribe is based on factors including other diseases you have and what drugs you are taking, how well you tolerate the nausea and heartburn associated with bisphosphonates, how well you tolerate needles and how well you adhere to dosing schedules.

For more information: The National Osteoporosis Foundation, 202-223-2226 or nof.org, or the National Institutes of Health Osteoporosis and Related Bone Diseases, 202-223-0344 or www.osteo.org.

Source: The Bergen County Record, N.J. Provided by ProQuest Information and Learning. Powered by YellowBrix.

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