Risk Assessment for Men

Who is at risk for osteoporosis?

Osteoporosis is a silent disease that causes bones to become thin and weak, often resulting in broken bones. It can happen to anyone; the disease has no age, gender or ethnic boundaries. Osteoporosis more commonly affects older, postmenopausal women, and individuals of Caucasian or Asian descent. This does not mean that others are not at risk for osteoporosis. Men, African-Americans and other populations get osteoporosis, too; they are just at a slightly lower risk than Caucasian or Asian postmenopausal women.

Why is it important to know my risk factors for osteoporosis?

It is important for you to identify your personal risks for osteoporosis. Knowing your risk factors is the first step in taking an active role in the prevention, early diagnosis, and treatment of osteoporosis.

Am I at risk for osteoporosis?

You may be at risk for osteoporosis if you answer “yes” to many of the risk factors that follow.

Check () if you…

are age 70 or older (the older you are, the greater the risk)
are Caucasian or Asian
are small and thin
have a parent who has/had osteoporosis or a broken hip
have a personal history of low-impact fractures (broken bones without trauma, such as a car accident or severe sports injury) during adulthood, x-ray evidence of spine fracture, height loss of more than 1-1/2 inches or stooped posture
have a low level of the hormone testosterone
have a history of long-term smoking (more than 1 pack a day for more than 5 years) or currently smoke.
consume alcohol to excess and/or have a history of alcohol abuse

Check if you have or have a history of any of the following chronic diseases/conditions often associated with osteoporosis and related fractures:

autoimmune disease including lupus
blood disorders – certain types such as leukemia, sickle cell disease
cancer – certain types such as lymphoma, multiple myeloma, metastatic, prostate, testicular
eating disorders – anorexia, bulimia
hyperparathyroidism (excessive parathyroid hormone)
hyperthyroidism (excessive thyroid hormone)
inflammatory bowel disease
kidney disease
immobility or bed rest for more than 6 months
liver disease
lung disease that is chronic (COPD)
malabsorption- from bariatric (obesity) surgery, celiac disease, Crohn’s disease, liver disease, pancreatic disease
neurological disorders – such as multiple sclerosis, Parkinson’s disease, spinal cord injury, stroke
organ transplant
rheumatoid arthritis

Check if you are taking or have taken any of the following medications:

Important: If you take any of these medications, do not stop or change the way you take them without medical advice from your healthcare provider.

aluminum containing antacids – such as Maalox or Mylanta taken for long periods of time
antiseizure medications – only some such as Dilantin (phenytoin) or phenobarbitol
androgen deprivation therapy- such as lupron, zoladex, or other medications used to treat prostate cancer
blood-thinning agents – such as long-term use of warfarin (Coumadin) or heparin
chemotherapy- some types
diabetes medications: some known as thiazolidinediones (TZDs) such as Actos, Avandia
gonadotropin-releasing hormone agonists (GnRH) – such as Lupron and zoladex used to treat endometriosis
immunosuppressants – cyclosporine A, methotrexate, FK506 (Tacrolimus)
proton pump inhibitors (PPIs)- such as Nexium, Prevacid, Prilosec
selective serotonin reuptake inhibitors (SSRIs)- such as Lexapro, Paxil, Prozac, Zoloft
steroids (such as prednisone or cortisone) in a dose of 5 mg or more taken for 3 or more months
thyroid medications taken in excess or lack of routine bloodwork to check TSH levels

Check if you have a longterm history of any of the following lifestyle risk factors:

low calcium intake – eating few, if any, dairy products or foods with calcium added and not taking calcium supplements
low vitamin D intake – seldom eat fatty fish or milk and take no multivitamin or vitamin D supplement
little physical activity – less than 60 minutes per week

Although risk factors may increase your likelihood of getting osteoporosis, having risk factors does not mean that you have or will get the disease. Only a bone mineral density (BMD) test can diagnose osteoporosis. It is important to be aware that the above checklist of risk factors is not complete. There are additional conditions and medications that may cause bone loss leading to osteoporosis; some of which are known as well as others that have not yet been identified. Men who do not have any of the above risk factors for osteoporosis may not be protected from developing the disease.

Risk assessment should increase your awareness of the potential to get osteoporosis and help motivate you to follow steps to protect your bones and to discuss your risks with your healthcare provider. When indicated, your healthcare provider may recommend a bone mineral density (BMD) test.

What if I am diagnosed with low bone mass or osteoporosis?

All medical conditions that cause osteoporosis should be treated. For example, if your osteoporosis is the result of testosterone deficiency, your healthcare provider may prescribe testosterone replacement therapy. The FDA has approved a number of medications for the treatment of osteoporosis in men. Speak to your healthcare provider about your bone health and to find out if an osteoporosis medication is right for you.

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