The risk of developing osteoporosis is largely influenced by age, gender and ethnicity. Ageing is the biggest risk factor, and the older you are, the bigger your risk.
Although the majority of patients with hip fractures are women, men also suffer from osteoporosis, and about 25% of hip fractures occur in older men. Men are however more likely to experience serious complications after a hip fracture, possibly due to the fact that they have more co-morbid diseases than women.
The following risk factors should convince you to have your bone health checked out!
If one or both of your parents suffered from broken bones, and you share their lifestyle and diet (which determines your peak bone density), chances are good that you may develop osteoporosis.
Previous fragility fracture
If you have already had a fracture following minimal trauma (falling from less than a standing height), you have double the chance of breaking another bone. Anyone who suffers a fragility fracture after age 50 needs to be assessed for osteoporosis. Treatment could prevent future fractures.
Some medications have side effects that could be harmful to bone, or increase the risk of fractures due to an increase in falls.
Patients taking any of the following medications should discuss their bone health with their doctor.
- Glucocorticoids (oral or inhaled for e.g. asthma, arthritis)
- Certain immune-suppressants (phosphatase inhibitors, calcineurin etc.)
- Thyroid hormone treatment (excessive doses are harmful to bone)
- Certain steroid hormones (LH releasing hormone agonists, medroxyprogesterone acetate)
- Aromatase inhibitors (used in breast cancer)
- Certain anti-epileptic drugs
- Proton pump inhibitors
Hypogonadism in men
Young men with low testosterone levels usually have low bone mass, which can be reversed through testosterone replacement therapy. At any age, acute hypogonadism due to e.g. orchidectomy for prostate cancer accelerates bone loss in men at a similar rate to than that of post-menopausal females -- something they will need treatment for.
Postmenopausal women and women who have had their ovaries removed, or went through early menopause (before age 45), need to be extra vigilant and live bone-healthy lifestyles. Hormone replacement therapy can be taken to slow down the rapid bone loss that follows menopause.
Certain medical disorders
• Rheumatoid arthritis
• Nutritional problems/gastrointestinal problems
• Chronic kidney disease
• Haematological diseases/malignancy (e.g. breast cancer, prostate cancer)
• Hypogonadal syndromes (Turner’s syndrome/ Klinefelter syndrome etc.)
• Endocrine disorders (e.g. diabetes, Cushing’s syndrome, hyperparathyroidism)
• Chronic immobility
If you have some of these risk factors and are concerned about your bone health, be sure to consult your doctor and get tested!
National Osteoporosis Foundation of South Africa NOFSA www.osteoporosis.org.za
International Osteoporosis Foundation IOF www.iofbonehealth.org, www.worldosteoporosisday.org
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