How do men compare with women? What is the risk of a fracture in a man compared with a woman? What treatments are available for men?
Roughly speaking, a man is “ten years behind” a woman in the risk of fragility fractures. So, for example, if women start to be screened for fragility from shortly after menopause then men should be screened from the age of 60.
Don’t forget that two women out of three will have a fragility fracture during their life, and one man out of three will have a fragility fracture. Being behind has its advantages.
Why am I unable to get good treatments for osteoporosis under the Pharmaceutical Benefit Service (PBS) just because I am a man?
Few studies are performed on men. It is easier to recruit women to studies in large numbers (more women are interested; more of them attend osteoporosis screening or menopause clinics). It is expensive for manufacturers to sponsor duplicate studies of men and women.
Although there appears to be no difference in bone biology between the sexes, the PBS (federal government department which subsidises medications) will not subsidise medicines for men when the effectiveness and the safety have not been separately confirmed in men.
Twenty years ago, a group of male Canberra residents brought a successful action against the PBS for discrimination on the grounds of sex. The medication was for osteoporosis – but one that we rarely use now.
At present, men can still take the same medication as women, but must pay the full price without government subsidy.
Is there any treatment that increases the amount of bone?
There is only one medicine that actually increases the amount of bone. This is teriparatide (trade name Forteo). To take this treatment, you need to inject yourself every day. It is very expensive. The Pharmaceutical Benefit Service only subsidises it for people with exceptionally fragile bones.