Many doctors don't test men for osteoporosis. For years, osteoporosis has been associated with elderly women with curved spines and hip fractures, not older men, who as a result, often go undiagnosed and untreated. Results from a study in the New England Journal of Medicine might change treatment options for men with osteoporosis. Researchers have shown that Fosamax, the Merck and Co. drug currently approved for osteoporosis in post-menopausal women, can also help men.

The two-year study, conducted at the Oregon Health Sciences University in Portland, compared 241 men diagnosed with osteoporosis taking the Fosamax versus those given a placebo, or dummy pill.

The researchers (nine of 12 of whom worked as consultants for Merck) found the medicine fought the symptoms of osteoporosis: it slowed the loss of height, decreased the amount of bone fractures, and increased bone mineral density in the spine and hip. Some of the side effects of the drug include gastrointestinal pain or heartburn.

But men themselves may still be resistant to getting the message that they should be tested for osteoporosis with a bone density test. According to a 1996 Gallup poll conducted on behalf of the National Osteoporosis Foundation, less than half the men polled thought it was likely a man could develop osteoporosis, and a quarter denied it was at all likely they themselves could get the disease.

Men and Osteoporosis

As a result, most men only show up in his office after a fracture, and are chagrined to find they are in the advanced stages of osteoporosis. Men are different than women in the course of their disease. Unlike women, who experience a great drop off in bone mass as their estrogen level falls at the time of menopause, men's bone loss starts about a decade later than women's and progresses more slowly. Additionally, men's bones are larger and denser to begin with, so they are more protected from bone disintegration.

Men at risk for osteoporosis include who use steroid drugs called glucocorticoids (e.g. prednisone) for diseases such as asthma, arthritis or lupus. Those who have been treated for prostate cancer by lowering their testosterone levels may also be the male equivalent of post-menopausal women who have lost their protective estrogen. Both hormones protect against osteoporosis. Other risk factors for men include smoking, alcoholism, calcium deficiency, a family history of the disease, being physically inactive, or simply getting older.

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