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Dear Savvy Senior,

Can men get osteoporosis or is it mostly a problem for women? When I fell and broke my wrist last winter, the ER doctor told me I might have osteoporosis, but I never followed up. What can you tell me?

—Almost 70

Dear Almost,

A lot of people think osteoporosis is only a women’s issue, but men can get it too — especially as they get older. And like women, men often don’t realize they have it until a bone breaks.

Osteoporosis is often called a silent disease because it weakens bones over time, making them thin, brittle and more likely to break, usually without any warning signs. While women are about four times more likely to develop it, men aren’t immune. About 2 million American men have osteoporosis, and another 12 million have low bone density, known as osteopenia, which can eventually progress to the disease.

One of the biggest problems is that men are less likely to be tested. Even after a fracture like yours, many never get a bone density scan. Doctors sometimes overlook it in men, and men themselves may not realize they’re at risk. The bones most often affected are the hip, spine and wrist, and hip fractures in particular can lead to serious complications and long recoveries.

Who is at risk

In women, menopause speeds up bone loss. In men, it usually happens more gradually, but age is still a major factor. Your risk rises if you are over 70, thin or underweight, smoke, drink heavily, have a parent with osteoporosis or have already broken a bone, as you have.

Certain medical conditions can also increase your risk. These include rheumatoid arthritis, celiac disease, low testosterone, overactive thyroid, COPD and kidney or liver disease. Neurological conditions such as Parkinson’s disease, multiple sclerosis or a past stroke can raise the risk because they affect balance and mobility.

Long-term use of corticosteroids, some prostate cancer treatments, acid reflux drugs, antidepressants and antiseizure medications can weaken bones too.

Testing

A smart next step is a bone density test, or DEXA scan. All men 70 and older should talk to their doctor about being screened. Men over 50 who’ve had a fracture or have other risk factors should get tested too.

The scan is simple, painless and takes only a few minutes. Medicare and most private insurance plans usually cover it.

Prevention

When it comes to protecting your bones, the basics really matter. Get enough calcium from foods like low fat milk, yogurt and cheese, leafy green vegetables, beans, almonds and canned salmon or sardines. Men under 70 need about 1,000 milligrams a day. Those 71 and older need 1,200 milligrams.

Vitamin D is just as important because it helps your body absorb calcium. Most adults over 50 need 800 to 1,000 international units daily, through sunlight, food or a supplement if needed.

Regular weight-bearing exercise such as walking, along with strength training two or three times a week, helps build and maintain bone. It also improves balance, which can prevent falls. You should also avoid smoking, and limit alcohol and caffeine.

Treatment

If testing shows significant bone loss, your doctor may prescribe medications such as Fosamax, Actonel, Reclast, Prolia, Forteo or Tymlos. Your doctor can explain the benefits and possible side effects of each to help you decide what is appropriate.

Since you have already had a fracture, this is not something to ignore. A simple test and a plan now could help you stay strong and avoid a more serious break down the road.

Send your questions or comments to questions@savvysenior.org, or to Savvy Senior, P.O. Box 5443, Norman, OK 73070.