Men’s Health: Osteoporosis

Ronald L. Scott
RScott@central.uh.edu

Osteoporosis is commonly thought of as a condition affecting only women, but a recent study indicates that far more men suffer from the condition than previously was recognized.  Males are rarely given bone density examinations, so many men may not discover that they have low bone density in time to treat the condition.  I was given a bone density exam as an educational exercise, and surprisingly found that I have osteoporosis, even though I have experienced few symptoms and have no risk factors for the condition.  In retrospect, I did exhibit one symptom of osteoporosis, but it was ignored.  On two separate occasions, I presented for treatment with broken bones.  However, since the reason for the breaks was fairly obvious (a skiing accident and sailing mishap), neither physician recommended a bone density measurement.  My treating physician now advises me of the positive correlation between broken bones and osteoporosis—even where the breaks are caused traumatically.

Earlier this year, the National Osteoporosis Foundation (NOF) issued a new report based on 2000 census figures.  The report estimates that in 2002 more than 14 million men in the U.S. will have osteoporosis or low bone mass, rising to 17 million men in 2010 and more that 20 million in 2020. The report found that the prevalence of low bone mass in men is much greater than that estimated in NOF’s 1997 report, primarily based on new research methodology.  See America’s Bone Health: The State of Osteoporosis and Low Bone Mass in Our Nation at http://www.nof.org/advocacy/prevalence/.

Physicians sometimes fail to diagnose or treat cardiac conditions in women since heart attacks are thought of as a “men’s disease.”  Likewise, physicians may fail to recognize that their male patients may have low bone density.  Even the well-respected National Conference of State Legislatures (NCSL) Health Policy Tracking Service titles its issue brief on osteoporosis “Women’s Health: Osteoporosis Coverage Requirements.”  See Issue Brief dated July 1, 2002 at http://www.hpts.org.

State laws mandating insurance coverage for bone density examinations also discriminate against men.  As noted in the NCSL issue brief, several states require that health insurance plans provide coverage for such exams, but a closer review of the statutes reveals that men are virtually excluded.  For example, Kentucky requires health insurance policies and HMO contracts to cover bone density testing for women over 35 years of age. See Kentucky Revised Statutes, § 304.18-0983.   Other states require testing of “high-risk or qualified individuals” defined in the above-cited NCSL issue brief as “estrogen-deficient individuals who are at clinical risk for the disease; individuals with vertebral abnormalities; individuals receiving long term steroid therapy…”   Men not yet exhibiting symptoms of osteoporosis are unlikely to qualify for coverage under such statutes.

Perhaps the recently released NOF report will force legislatures (and treating physicians) to recognize that men do suffer from osteoporosis and that men deserve to have the same access to bone density examinations as women.

08/20/02