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Orthopedics and Health

Male menopause, osteoporosis

The Male Menopause and Broken Bones

By Dr. W. Gifford Jones

November 21, 1999

So you're a man, and you believe only the weaker sex breaks bones. It's due to osteoporosis (brittle bones) you say. Well, you had better think again. Studies show that 20 to 30 percent of osteoporosis fractures occur in men. And that low testosterone levels in aging males may be responsible for many crippling hip and spinal fractures.

Aging men tend to think of heart disease or prostate problems as the primary threat to their health. But one in eight men over the age of 50 suffers from osteoporosis. Fractures due to brittle bones are serious. Men who suffer a hip fracture are three times more likely to die than women. 33 percent succumb within one year. And only 41 percent of men who survive a hip fracture regain their previous level of functioning. Osteoporosis is a silent disease until a fracture suddenly occurs. One 52 year old man remarked, "I found out I had osteoporosis when I broke some ribs coughing. I was just sitting in a chair when it happened!"

Another 60 year old man says, " I wasn't quite 50 when I fell and injured my back. After a few days of excruciating pain I went to the doctor who took X-rays. I was stunned when he told me the fracture was due to osteoporosis. Bone density studies showed I had lost 35 percent of my bone."

Robert Josse, Professor of Medicine, University of Toronto, makes a vital point. He says "Osteoporosis is only the risk factor for the disease. The real disease is 'fracture'."

Men should suspect osteoporosis if their pants become too long. Some males with osteoporosis can lose as much as several inches in height as spinal vertebra collapse. Think osteoporosis if someone in your family has suffered from this condition. Or if you're thin and small-boned. You're also at increased risk if you're white, a smoker, drink alcohol to excess or have too many cola drinks.

Corticosteroid therapy is a major risk factor. A British study revealed four times the risk of a vertebral fracture and double the risk of a hip fracture when patients are on high dose corticosteroids (more than 7.5 milligrams of prednisone daily).

To decrease the risk of osteoporosis the ideal remedy for everyone is a calcium rich diet. 0*0*0* This means drinking three glasses of milk a day starting at a young age which provides both calcium and other important nutrients. I have to tell patients over and over that milk isn't just for kids.

If you can't get sufficient calcium from the food store you need calcium supplements from the pharmacy.

"Exercise". There would be fewer broken bones in this country if people took the stairs rather than the escalator. Or walked for half an hour every day.

For years it's been known that estrogen, either the patch or pill, taken following the menopause is a prime way to prevent brittle bones in women. But what about the male hormone testosterone. Is it helpful for males?

One survey showed that only 78 percent of physicians believe men experience something similar to menopause. And only 44 percent of doctors associate low testosterone levels with bone loss. But increasing evidence demonstrates that a male andropause is a fact of life.

Dr. Josse says, "there probably is a male andropause in which testosterone secretion does decrease with age. And that this hormone deficiency may play a pivotal role in the development of bone fragility."

Studies also show that low testosterone levels exist in as many as 50 percent of men with hip and spinal fractures. Other reports from around the world indicate that low testosterone is associated with increased risk of brittle bones.

Professor E.O Abu and his colleagues at the Universities of Cambridge and Oxford report in the Clinical Journal of Endocrinology that, "testosterone has important effects on the human skeleton in both males and females."

Another study carried out at the University of Auckland, New Zealand, claims that testosterone treatment reverses the damaging effects of corticosteroids drugs on both the skeleton and soft tissues in men. And that it contributes to increased strength and a sense of well-being.

I've believed for years that more men will be treated for the male andropause similar to women on estrogen therapy. In Canada Andriol, a pill form of testosterone, is available.

My advice for men is to see your physician to assess your risk of osteoporosis. If the doctor decides there's increased risk of osteoporosis he or she may prescribe Andriol and other drugs to help circumvent a serious fracture. Prevention is always better than cure.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod