When we talk about osteoporosis we usually. Think about women, but osteoporosis affects men as well. In fact 1 in 8 men over the age of 50 are affected in Canada. This is a concern as these fragility fractures can increase the risk of illness and even death. They impact on chronic pain and hospital admissions.

Risk factors for bone loss in men include nutritional deficiencies, genetic factors, falling testosterone and estrogen in men as well as lifestyle factors such as alcohol and smoking. Certain medications can increase the risk off bone loss as well.

Lower testosterone as well causes decrease in muscle mass and loss of balance leading to more falls. But in men lower estrogen as well leads to bone loss and increase fracture risk.

Male smokers have a greater risk for osteoporosis than other men and even than women smokers.

Although it was expected that expected the risk would be worse for women, it was actually worse for men.

Women tend to have smaller, thinner bones than men, and they lose bone density when the production of the hormone estrogen decreases after menopause. Smoking can accelerate the loss of bone density.

This study looked at bone density and the severity of lung disease, and looked for small fractures in the vertebra of the spine in 3,321 current and former smokers as well as a group of 63 people who never smoked.

It was found that male smokers had a small, but significantly greater risk of low bone density, and more vertebral fractures, than female smokers. Such signs of osteoporosis were present in 58 per cent of study participants, and in 84 percent of people with a severe form of the smoking-related lung disorder known as chronic obstructive pulmonary disease (COPD).

Thirty-seven percent of the study participants had one or more vertebral fractures, and they were mostly male, older than the group average, more likely to be current smokers and had smoked for a longer time.

There have been limited studies in men on medication with an emphasis on female studies but newer medications indeed have been studied in men looking at safety and efficacy.

Approved medications for men include bisphosphonates and monoclonal antibody medication called denosumab.

Men and women can take some of the same lifestyle steps to reduce the risk of broken bones. Advice includes regular exercise and strength training as well as adequate calcium and Vitamin D.

It is also critical to assess alcohol and smoking as additional risk factors.