| Osteoporosis means that our bones are more porous | | | | percent of hip fractures and twenty percent of spinal |
| than normal and have lost some of their strength to | | | | fractures are in men. There may be various reasons |
| resist the forces we put on them in normal life. The | | | | why men are less likely to suffer from osteoporosis: |
| outer shell of a bone is known as the cortex and is | | | | they do not have a dramatic bone loss effect in |
| denser to provide strength and resistance to bending. | | | | middle age and they start off from a higher level of |
| The inner, honeycomb-like mesh is called cancellous | | | | bone density, losing less cortical bone in particular |
| bone and has its holes filled with collagen tissue, blood | | | | than women. |
| vessels and bone marrow. When osteoporosis occurs | | | | There are usually no signs of anything going wrong |
| the holes inside the bone become larger, with fewer | | | | as osteoporosis develops and the first sign of |
| cross-connecting support struts, reducing the | | | | something wrong is often the severe fracture pain of |
| strength of the bone. The effects are usually | | | | a broken wrist or spinal wedge fracture, perhaps |
| widespread but fractures typically occur in the spine, | | | | from a relatively minor input. The wedging which |
| hip and wrist. | | | | occurs in the thoracic spine is acutely painful and can |
| Being active and dynamic is not the typical view of | | | | produce significant disability which can become |
| the bony skeleton but it is a growing and changing | | | | chronic. Crush fracturing and wedging can occur |
| tissue which is constantly renewed over time, taking | | | | quietly and without the drama of severe pain, |
| between seven and ten years to complete the | | | | appearing as a kyphosis, a form of spinal curvature, |
| whole replacement. The renewal process is called | | | | or as a remarkable loss of stature. A severely |
| bone turnover and it can be much faster to replace | | | | kyphotic spine can cramp the ribcage and cause |
| the entire skeleton in a child, a process which can be | | | | pressure on the lungs and gut with consequent |
| as short as two years. The growth plates of our long | | | | problems. |
| bones close around sixteen to eighteen years of age | | | | 45% of men with osteoporosis have no identifiable |
| and at this time we stop gaining height and size. It is | | | | cause for their disease, with genetic factors likely to |
| however not before the middle of our twenties that | | | | be important in the large majority of cases. Having a |
| the process of increasing our bone density reaches | | | | history of osteoporosis in the close family |
| its highest level. | | | | predisposes to having a lower bone density and an |
| The balance of bone turnover then enters a phase | | | | increased risk of spinal fracture. Levels of |
| where there is equilibrium between the rate of bone | | | | testosterone are important in the maintenance of |
| breakdown and the rate of bone formation. From | | | | bone density and a low concentration is a major risk |
| middle age this balance shifts in favour of bone | | | | for osteoporosis, with a 70 year old man only |
| breakdown and we begin to lose bone as we age, | | | | producing about half the testosterone of someone |
| with osteoporosis occurring in some cases, especially | | | | of 30 years old. Testosterone can be replaced as a |
| in women after the menopause due to hormonal | | | | treatment if a hormone specialist thinks it is |
| changes. Factors which may increase the likelihood of | | | | necessary. |
| a man getting osteoporosis are low levels of male | | | | Steroids are strong anti-inflammatory medications |
| hormones, low body weight, smoking, high alcohol | | | | used for asthma and ulcerative bowel disorders as |
| intake, being very immobile, diet absorption problems | | | | well as for a number of less common conditions. Six |
| from conditions such as ulcerative colitis and long | | | | months treatment with a steroid such as |
| term steroid use for asthma. | | | | prednisolone can increase the levels of bone loss but |
| Osteoporosis will affect one in three women at some | | | | steroids are only used when they are vital for health. |
| time in their life and it is often considered a condition | | | | Steroid doses should never be changed by the |
| which afflicts women. However, it has been | | | | individual without careful consultation with a doctor or |
| recognised that osteoporosis affects men too, with | | | | the side effects of the change could be severe. |
| an incidence of one in twelve even though only thirty | | | | |