The TV commercials typically talk about menopause and grandmothers.
One depicts 61-year-old actress Sally Field planting flowers while praising her medicine for osteoporosis.
Yet the disease, so often associated with older women, is one that 45-year-old Tim Brokaw suffers, too.
With his bones deteriorating and becoming more fragile, the Newark factory worker had already crushed a disk in his back when he learned that he is among the 2 million American men with osteoporosis.
"I never really knew what it was until my doctor was telling me," Brokaw said of the diagnosis this year. "I'm only 45 years old, and I'm falling apart."
A lack of awareness about male osteoporosis is common among both
patients and doctors, according to experts.
Only in May did the American College of Physicians issue a clinical guideline advising doctors to screen older men for the disease.
"It's an important public-health issue," said Amir Qaseem, senior medical associate for the membership organization. "It's significantly underdiagnosed, undertreated and underreported."
And, according to the National Osteoporosis Foundation, it's about to become more common.
As more baby boomers reach retirement age, 61 million Americans could have osteoporosis or an at-risk level of low bone mass by 2020 -- a figure up from the 10 million and 34 million, respectively, today.
The disease, which causes low bone mass and can lead to fractures, often develops in women after the rapid hormonal changes of menopause. Because men lose testosterone more gradually, the onset of male osteoporosis tends to be on a 10-year lag.
"In the past, men didn't live long enough to develop osteoporosis," said Joseph Flood, a rheumatologist at Musculoskeletal Medical Specialists in Columbus. "Now we're realizing that, as men get into their 70s and 80s, that it's more likely they'll have it as part of the natural aging process."
Aside from aging, other causes for osteoporosis include inactivity, alcohol and tobacco use and certain steroid medications for conditions such as arthritis or asthma.
The disease is effectively prevented by exercising and taking calcium and vitamin D -- a message that women hear regularly from doctors and pharmaceutical advertising but that men don't.
Margaret Phillips, 75, knew the importance of calcium supplements for her health but didn't consider pushing her husband to take them until Tom, 79, suffered three collapsed vertebrae while fixing a lawn mower.
"I'm a nurse, and I had no idea he could get it," said Mrs. Phillips, of the North Side. "I just thought it was women with their little rounded backs."
The couple learned that Tom's 4-inch loss of height was also attributable to osteoporosis -- not just from general symptoms of aging, as they'd thought.
Other effects of osteoporosis can be fatal: Experts say that a quarter of hip-fracture patients older than 50, with their functional health diminished, die within a year after the accident.
Although women proactively seek bone-mineral density tests, men aren't often screened until they experience a fracture or other injury.
John Rumberger, medical director of PrevaHealth in Dublin, notices bone-density abnormalities in about a third of his male patients -- typically men ages 40 to 60 who were referred to the diagnostic center for heart, lung or colon scans.
He tells them that although osteoporosis is treated by bone-loss medications, it's preventable by following common health advice.
"The therapy is usually: Get some exercise, take some supplements that you can buy at Kroger, and you'll be doing fine," Rumberger said.
"The men don't know about it, and, therefore, don't pay attention."
"It's all just part of maintaining health."
asaunders@dispatch.com
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