Men can suffer from osteoporosis

DEAR DOCTOR K: Do men need to worry about osteoporosis? Doesn’t it affect mostly women?

DEAR READER: Osteoporosis is a disease that weakens bones and makes them more susceptible to breaks. You’re correct that women are more likely than men to develop osteoporosis, but that doesn’t mean men don’t have to worry about it. In fact, about 2 million men in the United States have osteoporosis.

There are two main reasons men are less vulnerable than women to bone loss. First, men start out with bigger bones and greater bone density. Second, certain hormones that affect bone density decline more gradually in men than in women.

When men under age 75 develop osteoporosis, it’s often because of treatment with certain drugs or an underlying condition. This is called secondary osteoporosis.

Other risk factors that are particularly relevant to men include:

• Low sex hormones. Men produce both estrogen and testosterone. Levels of both of these hormones decline as men age, and this can cause bone loss.

• Heavy alcohol use. Heavy drinking can damage bone health by reducing bone mass.

• Smoking. Many years of smoking can exacerbate the thinning of bones.

• Inactivity. Our bones respond to being challenged by becoming denser and stronger. The bones of the legs, hips and spine are strengthened by weight-bearing activities, and by exercises like walking or running.

• Gastrectomy. This operation, in which part or all of the stomach is removed, can reduce the amount of calcium the body absorbs. That, in turn, causes some thinning of the bones.

Heredity also plays a role. Clearly some men (like some women) are more vulnerable to getting osteoporosis, but we don’t understand all of the genetics involved.