WHEN TREATMENT BRINGS UP NEW PROBLEMS – A CASE REPORT OF MALE OSTEOPOROSIS

INTRODUCTION:Male osteoporosis’ prevalence has significantly increased with general population’s aging. Although traditionally considered a women’s disease, morbimortality rates associated with osteoporosis are higher in men. Consequences of osteoporosis in men are disregarded and often un(de)rdiagnosed and un(der)treated. CASE REPORT:Male, 55 years old, healthy, married, without children. He fractured left tibia and fibula and was submitted to conservative treatment, but a delay in bone healing was noticed after several weeks. In a clinical reevaluation with his Family Physician (FP), this one noticed at physical examination undeveloped sexual characters. The FP asked about sexlife and patient said he always had erectile dysfunction. In adition, he had no descendesse, so the FP thought about hypogonadism as a probable diagnosis, which was analitically confirmed and could justify osteoporosis. He then began antiresorptive therapy and testosterone. There was resolution of orthopedic problem and patient regained his sexlife. However, due to sexual activity’s high frequency, the wife start to decline it, leading to gradual family dysfunction. So, patient gives up testosterone treatment for family harmony’s sake. There’s an improvement in family functioning, however patient has marked mood swings that invariably interfere with their quality of life. At the moment, patient doesn’t know what to do – start testosterone or start an antidepressant…. CONCLUSION:This case shows how important it is seek secondary (and potentially reversible) causes of osteoporosis. The FP has a crucial role not only on the diagnosis, but also on the assessment of the impact on social and family functioning, through longitudinal and comprehensive care.