Osteoporosis, Underdiagnosed and Undertreated in Men

It is estimated that 54 million Americans have osteoporosis or osteopenia (low bone mineral density.) Additionally one in two women and up to one in four men, age 50 and older, will break a bone due to osteoporosis at some point in their lifetime. This is a serious problem for both women and men, but men are largely overlooked in prevention/treatment efforts.

New Study

The authors of this study looked backward at records of 9876 men in the USA Medicare system who suffered an osteoporosis related fracture. They found that 92.8% had no diagnosis of osteoporosis or received any treatment for low bone mineral density. They also found that fewer than 6% of men had a DEXA scan in the two years before they suffered a fracture. The authors noted that despite the presence of high risk factors for falls the majority of men in the study had little to no screening tests performed.

The authors found similar pattern of undertreating post fracture as well. They found that only about 10% of these men had bone mineral density testing and only 9% were treated with osteoporosis medication. They found that about 7% of men who suffered a fracture suffered a subsequent fracture. While this data is worse, it is known that even for women, after a fracture there is undertreating as well.


Men do have a risk for suffering osteoporotic related fractures. The rate is lower than women but this is still something to understand. The way our healthcare system is set up, it catches women at a far greater rate than men. Until there are major changes in Medicare, men over the age of 65 will need to advocate for themselves for diagnostic testing especially if they are at higher risk for a fall.

What increases your fall risk? Of course a loss of strength and stability is significant in increasing fall risk. Other factors include medication use such as, anti-anxiety, anti-depressants, sleeping aids, beta-blockers, and opioids. Some cancer treatments can reduce bone density including prostate cancer treatment.

The costs of suffering an osteoporosis related fracture can be large. Cost of care to repair the fracture, cost for rehabilitation post surgery, cost of adjusting to life post fracture. Since most people who suffer an osteoporosis related fracture the risk for prolonged consequences is huge. The right thing to do is to understand that a major risk for decreased bone density is related to lifestyle. Decreasing health, decreasing activity, decreasing strength as people age. The best thing to do is to live a healthy lifestyle. Healthy nutrition, exercise, activity level.


From a nutritional level we typically talk up taking calcium, but there are cofactors which are important to take so your body will actually absorb that calcium. Vitamin D has an important role in building strong bones, it does so much more and you should look for those posts. Additionally magnesium is important. In fact it might be more important for you to take magnesium than calcium. Magnesium plays an important role in regulating calcium balance in the body through several different physiological functions. Check out this post for a chart on foods high in Mg. but know this getting your daily amount from what you eat alone is difficult. As with many vitamins and nutrients taking supplements is an important part of getting what we need every day.

In order to help stimulate your body to need to improve bone density, we need to stress our bones. This requires strength training. Some sources say impact exercises is enough gut I don’t think so. Studies done from a traditional healthcare standpoint find exercise alone does not improve bone density. I think these studies are severely flawed because they rarely include any significant, serious strength training. I think serious strength training or weight lifting is important to build bone.

What Can We Do For You

If you are concerned about strength training we have options that might be right for you. Our BStrong4Life program is perfect for people looking to increase strength to impact bone density and improve your daily life. We have patients who have improved on DEXA scans after utilizing our BStrong4Life program. We have many patients who have found an improvement in ability to perform better in their daily lives due to increased strength.

We would be happy to be a resource for your nutrition. We offer a class every February on heart health which has a heavy emphasis on diet/nutrition. We offer some supplements in the office and can point you in the direction of what you should be taking.

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