Message from Harvard Men's Health Watch

Message from Harvard Men's Health Watch

Men need to manage their bone health as much as women do.

Published: July, 2020

Most people think of osteoporosis as a women-only health problem, but older men also need protection from this bone-weakening disease.
About one in four men older than 50 will break a bone because of osteoporosis during his lifetime, according to the National Osteoporosis Foundation. And research has found that compared with women, older men are more likely to die following a fracture related to osteoporosis.

"Maintaining good bone health can not only help protect men from osteoporosis, but also reduce their risk of serious breaks or fractures from falls or other injuries," says Dr. Joel Finkelstein, an endocrinologist at Harvard-affiliated Massachusetts General Hospital.

Some prescription drugs accelerate bone loss

Certain drugs are associated with more significant bone loss over time and may raise the risk of osteoporosis. Consult your doctor if you take any of the following:

  • selective serotonin reuptake inhibitors (SSRIs)
  • corticosteroids (such as prednisone)
  • androgen deprivation therapy to treat prostate cancer
  • anticonvulsants
  • certain chemotherapy drugs.

A break in the cycle

Osteoporosis is a disease that weakens bones and makes them more likely to break. During your life, bones undergo a continuous maintenance cycle in which they are simultaneously broken down and rebuilt.
Osteoporosis occurs when the body loses bone faster than it can rebuild it. Eventually, bones become thinner, more porous, and weaker, which makes them susceptible to fractures. Certain lifestyle factors can raise a man's risk of osteoporosis, such as smoking and heavy alcohol use.
Measuring bone density can confirm early osteoporosis. While there is no guarantee that you can always protect yourself from the disease or slow its progress, following certain strategies can be helpful, according to Dr. Finkelstein. For example:
Weight-bearing exercise. One way to protect your bones from fractures is to lower your risk of falls. Regular exercise does this by keeping your muscles strong and improving your balance, says Dr. Finkelstein.

Some experts also recommend specific weight-bearing activities that place pressure on your bones, especially in the hips and spine, which can help with bone growth. Examples include walking (especially speed walking), running, stair climbing, racquet sports, hiking, and dancing. These activities focus on the lower body, so make sure to add some upper-body exercises that stimulate the bones in your wrists and arms, using free weights, resistance bands, or gym weight machines.

Calcium and vitamin D. Both calcium and vitamin D work together to keep bones healthy. Calcium is a crucial building block of bone, while vitamin D helps the body absorb calcium. Calcium guidelines for men ages 50 to 70 are 1,000 milligrams (mg) per day and 1,200 mg for men ages 71 and older. Recommendations for vitamin D are 600 international units (IU) daily until age 70 and then 800 IU afterward.

It's often easy to get enough calcium through a regular healthy diet. For instance, one cup of cooked spinach has about 245 mg. A cup of whole almonds has 378 mg, and an 8-ounce glass of calcium-fortified orange juice has about 350 mg.
About 10 to 15 minutes of sunlight exposure a few days a week (or 30 minutes if you have darker skin) can usually enable the body to produce sufficient vitamin D. But that can be a challenge in the winter or if you live in a northern climate.

It also is tough to get enough vitamin D through food. Some good sources are fatty fish like trout and salmon, which serve up about 600 IU in a 3-ounce serving. A half-cup of white mushrooms has 366 IU.
Vitamin D supplements can help people who need to avoid the sun or don't think their diet provides enough. A 1,000-IU vitamin D supplement daily is safe and should be sufficient.

Medications. Low testosterone levels also can contribute to osteoporosis. Testosterone therapy is often recommended for men whose doctors confirm they have low testosterone levels and low bone density.
Men with normal testicular function who have osteoporosis can improve their bone density by taking a bisphosphonate drug, such as alendronate (Fosamax, Binosto) or risedronate (Actonel, Atelvia).