How is osteoporosis diagnosed?
Diagnosis is based on your medical history and a physical exam. Bone density testing measures the density of your bones using a special X-ray. From this information, your doctor can estimate the strength of your bones. Your doctor may also do blood and urine tests to rule out other problems that may cause bone loss. Blood tests can also tell if low levels of testosterone or estrogen in your body are causing bone loss.
The National Osteoporosis Foundation (NOF) recommends that all men age 70 and older routinely have a bone density test to screen for osteoporosis. The NOF also recommends that you and your doctor check your fracture risk using a tool such as FRAX (Fracture Risk Assessment) starting at age 50. This tool can help you decide if you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.
Ultrasound is sometimes offered at events such as health fairs as a quick screening for osteoporosis. Ultrasound by itself isn't a reliable test for diagnosing osteoporosis. But if results of an ultrasound screening find low bone density, your doctor can help you decide whether you should have a bone density test.
How is it treated?
Treatment for osteoporosis may include adopting healthy habits and taking medicine to reduce bone loss and to build bone thickness. Medicine can also give you relief from pain caused by fractures or other changes to your bones.
Medicines used to prevent or treat osteoporosis include:
- Bisphosphonates, such as alendronate (Fosamax), risedronate (Actonel), and zoledronic acid (Reclast). These medicines slow the rate of bone thinning and can lead to increased bone density.
- Denosumab (Prolia). This medicine may be used for men who are at very high risk for bone fracture, such as men who are receiving androgen deprivation therapy (ADT) for prostate cancer.
Parathyroid hormone (teriparatide [Forteo]). This medicine is used for the treatment of men who have severe osteoporosis and who are at high risk for bone fracture. It is given by injection.
If you have low testosterone levels, your doctor may give you hormone therapy (shots, gels, or patches) to prevent osteoporosis. But hormone therapy to treat osteoporosis has not been approved by the FDA. If testosterone therapy is recommended, discuss the risks and benefits with your doctor.