Should a man be tested for osteoporosis?

I thought so. My doctor thought so, but the medical assistant as I checked out said men do not get osteoporosis and wondered why I got tested.  She, like way too many, was completely misinformed. Men do get osteoporosis.

Granted, most of the risk factors for osteoporosis are female specific.  These include early menopause, thinness or small frame, being postmenopausal and particularly having had early menopause, and abnormal absence of menstrual periods (amenorrhea) (NIH).

But not all risk factors relate to women. There are other risk factors that may relate to both men and women, and I have four of them: a family history of osteoporosis (maybe), glucocorticoid medications often prescribed to treat rheumatoid arthritis can trigger significant bone loss, low calcium intake (milk makes my blood sugar go crazy) and the prolonged lack of physical activities brought on by RA (NIH).

Now there is a reason all this came to a head for me last month.  I broke my foot.  It was an odd break, I was just walking down the sidewalk, I stepped, and ouch it hurt so bad I came up lame.  It hurt badly and I had a painful limp but I walked away.  The next day it still hurt, and the day after I went to the doctor (podiatrist) and told him my story.  Less than an hour later we had the X-ray and sure enough my foot was broken in 3-5 places.

A podiatrist put me in a boot, and I had to limp around for a few days and remain off of it as much as possible for two weeks.   I did my best but upon returning to the doctor, I learned my foot was  still broken and will likely remain that way until I have it surgically pinned.  The good news is that I need not have it done quickly or even at all so long as I am comfortable with walking around with it hurting.  No real damage will be done, but no marathons either.

it’s what the podiatrist then said that prompted this post.  He suggested that with my mother’s history and the ease it was broken I should ask the rheumatologist about osteoporosis just to rule it out.

Two weeks later I met with the rheumatologist and we talked.  He was not concerned about the foot breaking, saying it was not solely an indication of osteoporosis, but he understood the history regarding my mother, the lack of calcium intake and the long time use of glucocorticoid medications might be indicators of a deeper problem.  So he ordered the test.

What happened next floored me.  The medical assistant who checked me out, looked at my paper work and remarked men do not get osteoporosis so this procedure was unneeded.  I remarked the doctor thought it was and that I felt comfortable having it done, given the history.  I have to say that her comment absolutely threw me into a mental spiral.

I cannot even count the number of times I have been so self-conscious because I am a male and I have rheumatoid arthritis, a disease that predominately strikes females. Now  I felt I had to defend myself to a medical assistant checking me out about osteoporosis, another supposed female disease.

I was angry.  Mentally I could rationalize this as a slip of the tongue by a well-meaning lady, but to me it was bigger.  It was a challenge to being male for no reason. Men do get osteoporosis.

Maybe the risk was low for me.  Maybe in 8 out of 10 cases the rheumatologist would say let’s pass on the test, but I was one of those two cases where it was thought a good idea to screen.

It is amazing how a random, misinformed comment can send me into a spiral of self-doubt, questioning, and self-reflection about a medical issue; but it did.  I am certain the medical assistant meant no harm, it was a random comment not meant to judge or hurt; but it did.  Largely because it reminded me of societal and self-views that men must be strong, brave, tough, and we are to keep our vulnerabilities to ourselves.  In that moment when the medical assistant made the comment I was exposed, vulnerable and alone.  It was a most uncomfortable feeling.

I do not have osteoporosis.  The test came back fine.  But that is really beside the point.  People often ask why men do not go to doctors.  The truth is men have egos of glass, and even a little comment not meant to judge can shatter them.  A lone medical assistant with an ignorant comment can make a man feel about the size of a peanut.  But in the end that is not the fault of the medical assistant, it is my fault I felt devalued, which gives me something else to work on. Well at least I have something to talk to my therapist about.