Men at risk of Osteoporosis
What disease is under recognised but deadly in men? The surprising answer to that is Osteoporosis. Traditionally thought of as only afflicting women, osteoporosis is markedly undertreated and under diagnosed in men. Despite having clearly delineated risk factors, to date there are no universal screening procedures in place for use by primary-care physicians. The subject remains challenging, calling for a simple, effective and uniform set of recommendations to be used by PCP’s and specialists alike. Responding to this unmet need is an example of the many male-specific topics that the International Society of Men’s Health hopes to tackle in the near future. At the Men’s Health World Congress 2010 experts from around the world will gather to share varying opinions regarding screening, prevention and treatment of osteoporosis in men as well as other issues pertinent to men’s health.
Sticks and stone may break men’s bones
Men’s bones are different to women’s- quite simply they break differently. Tailoring specific guidelines for men is a work in progress and is very much a “hot topic”. Case in point: results for DEXA screening in men are based on female reference ranges. Leading to questions for future discussion: “Are we even testing the right bones?” and “Do these reference ranges correlate to men?” Fracture prevention is multi-factorial, men should be educated and encouraged to maintain muscle mass, ensure adequate intake of Calcium and Vitamin D. For elderly male patients in particular, medications associated with falls should be used judiciously. These include commonly prescribed medications such as: diuretics, anti-arrhythmics, antidepressants and most sedatives.
An experts opinion
Prof. Eric Orwoll, Scientific Committee Member of the Men’s Health World Congress, is the director of the Bone and Mineral Clinic and Bone Density Lab at Oregon Health & Sciency University. A renowned expert in the field Prof. Orwoll states, “Osteoporosis in men is an important health issue, especially in the elderly. Recent advances have improved the understanding of which men are at risk, and of the measures that are effective in preventing and treating the disorder.”
Gender specific risk factors
Men, like women, share many of the same risk factors for developing osteoporosis: Age greater than 70, low body mass index (BMI), and prolonged use of corticosteroids are a few examples. Diet and lifestyle factors such as alcohol consumption, cigarette smoking, low dietary intake of calcium and vitamin D are also contributing factors- of which are more commonly associated with men. Gender-specific risk factors worth highlighting include androgen deprivation therapy as well as hypogonadism (low testosterone levels). For physicians this translates into increased vigilance when encountering a patient being medically treated for prostate cancer or suffers from erectile dysfunction.
Hot Topics: Screening, Prevention and Treatment
Current conventional pharmacological treatment includes appropriate use of bisphosponates, calcitonins and parathyroid hormone where indicated. Goals of the ISMH include a consensus regarding these precise indications, i.e. which patients to treat and when to begin therapy. Controversial therapies, such as testosterone supplementation and its role (if any) in treating osteoporosis will be discussed at length at the Men’s Health World Congress. The promising role of estrogen and SERM’s for treating men with osteoporosis is also sure to encourage friendly debate. Participants will discover all encompassing aspects of osteoporosis in men, ranging from diagnosis to advances in therapy.