What is osteoporosis?
Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, and wrist.
What causes osteoporosis?
Osteoporosis is caused by a lack of bone strength or bone density. As you age, your bones get thinner naturally. But some things can make you more likely to have the severe bone thinning of osteoporosis. These things are called risk factors. Some risk factors you can change. Others you can't change.
Risk factors you can't change include:
- Your age. Your risk for osteoporosis goes up as you get older.
- Loss of the male hormone testosterone. As you age, your body makes less of this hormone. Some medical treatments, like using corticosteroids or taking medicines to treat prostate cancer, can also lower the level of testosterone in your body.
- Low estrogen levels. Evidence suggests that low levels of estrogen in men can lead to bone loss.
- Certain diseases of the:
- Hormone (endocrine) system, such as Cushing's syndrome, hyperparathyroidism, and hyperthyroidism.
- Stomach and intestines (gastrointestinal diseases), such as malabsorption, Crohn's disease, inflammatory bowel disease, and chronic liver disease.
- Your family background. Osteoporosis tends to run in families.
- Having a slender body frame.
- Your race. People of European and Asian background are most likely to get osteoporosis.
Risk factors you can change include:
- Not getting enough calcium and vitamin D.
- Not getting enough weight-bearing exercise.
- Drinking too much alcohol. Heavy alcohol use (more than 2 drinks a day) can decrease bone formation. It also makes you more likely to fall.
- Taking medicines that can affect bone growth and repair. Your doctor can tell you if you are taking any of these medicines. He or she can also help you understand if the benefit of the medicine is greater than the risk.
Experts suggest that older men talk to their doctors about osteoporosis and have bone density tests done if they are at risk.1
How is osteoporosis diagnosed?
Diagnosis is based on your medical history and a physical exam. Bone density testing measures the density of your bones using a special X-ray or CT scan. From this information, your doctor can estimate the strength of your bones. Your doctor may also do blood and urine tests to rule out other problems that may cause bone loss. Blood tests can also tell if low levels of testosterone or estrogen in your body are causing bone loss.
National Osteoporosis Foundation (NOF) recommends that all men age 70 and older routinely have a
bone density test to screen for osteoporosis. The NOF also recommends that you and your doctor check your fracture risk using a tool such as FRAX (Fracture Risk Assessment) starting at age 50. This tool can help you decide if you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.
Ultrasound is sometimes offered at events such as health fairs as a quick screening for osteoporosis. Ultrasound by itself isn't a reliable test for diagnosing osteoporosis. But if results of an ultrasound screening find low bone density, your doctor can help you decide whether you should have a bone density test.
How is it treated?
Treatment for osteoporosis may include adopting healthy habits and taking medicine to reduce bone loss and to build bone thickness. Medicine can also give you relief from pain caused by fractures or other changes to your bones.
Medicines used to prevent or treat osteoporosis include:
- Bisphosphonates, such as alendronate (Fosamax), risedronate (Actonel), and zoledronic acid (Reclast). These medicines slow the rate of bone thinning and can lead to increased bone density.
- Denosumab (Prolia). This medicine may be used for men who are at very high risk for bone fracture, such as men who are receiving androgen deprivation therapy (ADT) for prostate cancer.
- Parathyroid hormone (teriparatide [Forteo]). This medicine is used for the treatment of men who have severe osteoporosis and who are at high risk for bone fracture. It is given by injection.
If you have low testosterone levels, your doctor may give you hormone therapy (shots, gels, or patches) to prevent osteoporosis. But hormone therapy to treat osteoporosis has not been approved by the FDA. If testosterone therapy is recommended, discuss the risks and benefits with your doctor.
How can you stay healthy when you have osteoporosis?
You can slow osteoporosis with new, healthy habits.
- If you smoke, quit.
- Limit your use of alcohol.
- Get plenty of weight-bearing exercise. Walking, jogging, and lifting weights can make your bones stronger.
- It's important to get enough calcium and vitamin D in your diet. You need calcium and vitamin D to build strong, healthy bones. Try dark green vegetables, yogurt, and milk (for calcium). Eat eggs, fatty fish, and fortified cereal (for vitamin D). Your doctor might also tell you to get more calcium and vitamin D by taking supplements.
- When you have osteoporosis, it's important to take steps to prevent falls. You can start by making your home safer.
- Make sure there's enough light in your home.
- Remove throw rugs and clutter that you may trip over.
- Put sturdy handrails on stairs.
Making even small changes in how you eat and exercise, along with taking medicine, can help prevent a broken bone.
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
Actionsets are designed to help people take an active role in managing a health condition.
- Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
- Healthy Eating: Taking Calcium and Vitamin D
Learning about osteoporosis:
- What is osteoporosis?
- What increases my risk for osteoporosis?
- Can a test find osteoporosis early?
- What is a bone density test?
- Should I get a bone density test?
- What are bisphosphonates for osteoporosis?
- What is denosumab?
- What is teriparatide?
- What hormone therapy is available for men?
- Will I need surgery?
Living with osteoporosis:
- How can I get enough calcium to reduce my risk of fractures?
- What are some ways that I can prevent falls in my home?
Organizations National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), National Institutes of Health 1 AMS Circle
Bethesda, MD 20892-3675
1-877-22-NIAMS (1-877-226-4267) toll-free (301) 495-4484 (301) 718-6366 (301) 565-2966 email@example.com www.niams.nih.gov
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research.
The NIAMS website provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases. National Osteoporosis Foundation
(NOF) 1150 17nd Street NW, Suite 854
Washington, DC 20036
(202) 223-2226 (202) 223–2237 www.nof.org
The National Osteoporosis Foundation (NOF) funds
research and publishes educational material about osteoporosis for consumers
and health professionals. The NOF also provides information about bone density
testing sites, new treatment, and local groups interested in osteoporosis. The
foundation's mission is to prevent osteoporosis, promote lifelong bone
health, help improve the lives of those affected by osteoporosis and related
fractures, and find a cure. NIH Osteoporosis and Related Bone Diseases—National
Resource Center 2 AMS Circle
Bethesda, MD 20892-3676
(202) 223-0344 (202) 293–2356 (202) 466-4315 NIHBoneInfo@mail.nih.gov www.niams.nih.gov/bone
The NIH Osteoporosis and Related Bone Diseases—National
Resource Center is a government resource center that helps health
professionals, patients, and the public learn about and locate current
information on metabolic bone diseases such as osteoporosis, Paget's disease,
osteogenesis imperfecta, and hyperparathyroidism. National Institute on Aging www.nia.nih.gov
- Fitness: Getting and Staying Active
- Getting Enough Calcium and Vitamin D
- Health Screening: Finding Health Problems Early
- Hip Fracture
- Osteoporosis Risk Factors
- Quitting Smoking
- Testosterone for Osteoporosis
- Types of Osteoporosis
Qaseem A, et al. (2008). Screening for osteoporosis in
men: A clinical practice guideline from the American College of Physicians.
Annals of Internal Medicine, 148(9):
680–684. Also available online: http://www.acponline.org/clinical_information/guidelines/guidelines.
Other Works Consulted