Hip Fractures in Men: The Estrogen Implication

Estrogen. Long considered female oriented hormones, has been found to be implicated in the increased risk of hip fracture in men. While bone density is a crucial issue for both men and women, with aging, the level of estrogen hormones has become a key, predominant factor, in addressing the likelihood of a fracture occurring in both genders. With the implication the estrogen hormone has on the hip fracture prevalence in men, the routine blood panel health screenings, for men, may soon include estrogen level confirmations. Understanding the role of estrogen in male bone health, and the implication estrogen plays on hip fractures, may decrease the incidence of hip fractures in men and, therefore, improve male mortality levels.

For men, a hip fracture results in a 50% chance of institutional care with very little chance of restored activity to the level and degree as that prior to the hip fracture incident. Even more unfortunate is the statistic that one-third of men, suffering from a hip fracture, will die within one year of the non-traumatic incident. While these statistics are significant to the mortality of men, very little research has been done to determine what, if any, the implication of hormones play on the bone health of men.

With recent discovery, estrogen has been determined to play a key role in the bone density of men as well as women. In men, however, the combination of low testosterone, in addition to low estrogen, attributed to more hip fractures than any other hormone level combination. While smoking is a health hazard, attributing to osteoporosis, low hormone levels, in men, are also of concern. So, what does this mean for men?

While it is not recommended that men begin estrogen hormone replacement therapy, the research does confirm some health modifications may need to take place in men with low estrogen levels. Within a standard male health screening, physicians should incorporate estrogen level verification, on a regular basis, as part of the standard blood work request. If estrogen levels are determined to be low, aging men may be required to modify diet and exercise programs similar to that recommended for aging women. Such changes may include increased Vitamin D intake, increased calcium intake and weight bearing exercise for, at least, 30 minutes per day, three to four times per week.

At present, most family practitioners do not routinely request estrogen level verification as part of the health screening for a male patient. When consulting your physician regarding disease, illness or routine, preventative health care, request the addition of estrogen level blood work to ensure the risk of low bone density, and possible hip fractures, are understood. By doing so, it may decrease the likelihood of a life threatening fracture and, therefore, result in a decrease in early mortality of men.

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