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When the term "osteoporosis" is mentioned, it's often associated with women, especially those post-menopausal. However, this association overlooks the significant fact that men are also at risk.

Many men over 50 suffer from the silent effects of this bone-thinning disease without knowing it. Compounding this issue is low testosterone, an underreported cause of weak bones and increased fracture risk in men.

The overlooked risk

According to Dr Vineesh Mathur, Director, Orthopaedics, Medanta, Gurugram, bone loss in men typically occurs quietly over time. Often, the first indication is a fracture, by which point a considerable amount of bone has already eroded. Recovering from a fracture is almost always more challenging and takes longer for men than for women. A key, often hidden, factor is declining testosterone levels. While ageing is associated with a decrease in testosterone, this decline has significant implications for bone health.

The link between testosterone and bone strength

Testosterone isn't solely responsible for muscle strength or libido; it's also critical for bone health. Testosterone promotes new bone development and slows the breakdown of existing bone. Unfortunately, low testosterone levels in men can accelerate bone loss and increase the risk of fractures, particularly in the hips, spine, and wrists.

Low testosterone, medically defined as hypogonadism, can occur for various reasons, including performance-enhancing drugs, gradual age-related decline, chronic health issues, certain medications (especially steroids), and diseases like diabetes or kidney disease. Potential signs, such as fatigue, loss of muscle strength, decreased libido, or even a fracture from a seemingly minor fall, are often easy to overlook. These subtle changes are frequently attributed to normal ageing or simply ignored.

Warning signs men shouldn't ignore

Often termed a "silent disease," osteoporosis frequently presents without noticeable symptoms until it has progressed significantly. However, certain warning signs in men, such as persistent back pain, gradual loss of height, poor posture, and unexplained fractures, could indicate the presence of osteoporosis. When men have major osteoporosis risk factors, it's crucial to discuss bone health with their doctor. Ideally, they should be evaluated and, if applicable, undergo a bone density scan and baseline hormone tests to identify and address the issue before it worsens.

Taking charge of bone health

The good news is that osteoporosis in men can often be prevented and effectively managed. Regular physical activity, especially weight-bearing exercise performed a few times per week, can help maintain good bone density. A diet rich in calcium and vitamin D, along with avoiding smoking and limiting alcohol consumption, can also contribute to maintaining bone density. Hormone therapy to address low testosterone may be an option if testosterone levels are contributing to bone loss, but it's essential to seek a doctor's guidance first. Hormone therapy is not appropriate for everyone and should only be pursued under medical supervision.

It's time to change the stereotype that osteoporosis is solely a women's health issue. Men are also at risk, and their outcomes can be just as severe. The earlier the issue is recognised, the better the chances of managing it effectively. Men over the age of 50 and those who know men over 50 need to be aware. Don't wait for a fall to realise that something isn't right. Strength comes from the inside, and it's never too early to protect it.