Secondary Causes

What are the secondary causes of osteoporosis in men?

Many of secondary risk factors for men are the same as those for women such as taking medications like steroids or having certain diseases that increase the likelihood of bone loss and/or osteoporosis.

Testosterone is the bone-protective hormone for men; just like estrogen is the bone-protective hormone for women. Men do not have a rapid loss of testosterone at midlife so they do not experience an accelerated bone loss like that of women at menopause. Instead, it is common for men to experience a slower bone later in life than women associated with the age-related decline in testosterone levels.

There are some diseases, conditions or certain medications that cause men to make too little testosterone. For example, men with prostate cancer may take one of the gonadotropin-releasing hormone agonists, lupron or zoladex. These medications are often necessary to treat the underlying disease (prostate cancer) but they also decrease testosterone levels. This may result in an increased risk for bone loss and osteoporosis.

Heavy alcohol consumption or alcoholism and smoking are important risk factors for osteoporosis in men that should be modified.

What is the major cause for fractures in men?

Falling is the major cause for fractures among men with osteoporosis. Some frequent causes for falls include:

• excessive thinness or frailty due to chronic disease or malnutrition
• muscle weakness or neurological diseases such as Parkinson's disease
• dizziness caused by certain medications such as narcotics, sleep medication, or blood pressure medication
• visual or hearing impairment, or
• problems with mental alertness or cognitive function.

Clearly, falls can be related to many diseases, conditions, and medications but it is common for falls to simply be the result of an avoidable accident. Fall prevention strategies are important for everyone especially men with osteoporosis who are more likely to break a bone in the event of a fall.