What makes male osteoporosis a worrying problem is that men are more likely to die after a fracture. The Garvan Institute has found men have a 3.2-fold increased risk of death after they break a bone, compared with a 2.2-fold greater risk in women. It is not clear why, although one theory is that men are more likely to have other illnesses, such as heart disease.

Men are also more likely than women to incur a second fracture - their risk is four times greater after their first fracture, while in women it is twofold.

The disease is costing Australia about $7 billion annually and causes close to 100,000 fractures every year. It was declared a national health priority by the federal government in 2002, and the initiative was renewed in 2006 with funding until 2010.

Yet little is being done to tackle the problem, particularly in men. Fewer than 20 per cent of people who break a bone are treated to prevent further fractures. In men, up to 95 per cent remain without treatment.

"The big challenge is with a lot of medical professionals. We see GPs, physios and other physicians treating people who have been admitted for wrist fractures. They're in their 50s and have fallen over in the street, and no one is looking at whether they have osteoporosis," says the chief executive of Osteoporosis Australia, Judy Stenmark.

Hip fractures are the most costly osteoporotic fractures, both in terms of treatment and morbidity. However, every bone in the body other than the head and neck can fracture due to osteoporosis - most common are the wrist, spine, ankle, rib and hip. The peak age for osteoporotic fractures is 70 for women, although hip fractures tend to occur later.

"Three out of four women who have spine fractures don't know they have them. They break a vertebra and may have back pain and gradually it heals and even that pain goes away," says Professor John Eisman, the director of the bone and mineral research program at the Garvan Institute.

But studies have shown there is at least a twofold increase in the risk of hip fracture after an osteoporotic fracture of another bone. The only fractures that are not associated with increased risk of subsequent fractures are the ankle in women and the ribs in men.

Osteoporosis has no symptoms, other than possibly height loss. The only way of confirming you have the disease is through a non-invasive bone density test, such as an X-ray that measures the density of minerals in your bones. Since last year it has been available under Medicare for anyone over 70 or for younger people who have had a fracture or who have certain conditions that may increase their risk of osteoporosis.

Osteoporosis Australia is pushing for that threshold to be lowered to 65 or 60 and, while there is no evidence to support mass bone density screening, anyone who sustains any unusual fracture should suspect osteoporosis and consider being tested, Stenmark says.

Treatment for osteoporosis is showing clear benefits, with a relative reduction in the risk of subsequent fractures dropping by 35 to 55 per cent. One study of older men and women in Australia who had had a hip fracture found a 30 per cent drop in the risk of death if they were treated.

There are several approved options for drug therapy. Selective Oestrogen Receptor Modulators (SERMs), such as raloxifene, mimic the action of oestrogen to reduce bone loss and have been shown to reduce the risk of spinal fractures by up to 50 per cent. Bisphosphonates such as risedronate (Actonel) and alendronate (Fosamax) improve bone density and reduce the risk of osteoporotic fractures by 30 to 50 per cent.

A new but expensive option is strontium ranelate, which increases bone formation and is showing great promise in reducing spine and hip fractures. Parathyroid hormone is also occasionally used to stimulate bone formation and increase bone density.

Hormone replacement therapy has had a bad press recently due to its links with breast cancer, cardiovascular disease and deep vein thrombosis, but studies have shown that it reduces the relative risk of hip fracture by a third and of any fracture down by a quarter in the general population.

"If you are a woman and particularly if you have menopausal symptoms, you can think about using HRT," Eisman says. "There's probably a zero sum gain, but if you feel better you are not doing something that's stupid."

However, despite its proven benefits, treatment for osteoporosis is actually decreasing.

Tony Hobbs, a GP and the chairman of the Australian General Practice Network, points out that until recently screening and treatment for osteoporosis was not available. Most GPs are involved more with prevention, he says, but it is a problem he believes they should be more aware of as the population ages.

Not only are doctors failing to treat osteoporosis, there has been a big downturn in the first few months of this year in patients getting their prescriptions filled due to community misunderstanding about potential side effects of the drugs.

Last year one media outlet linked bisphosphonates with osteonecrosis of the jaw, a nasty condition in which bone will not close after dental treatment.

The report was inaccurate, Eisman says. There is a 1 or 2 per cent increase in osteonecrosis of the jaw for people receiving multiple frequent intravenous bisphosphonates as part of their chemotherapy for breast cancer or multiple myeloma. But international studies have shown that risk is as low as one in 100,000 for people being treated for osteoporosis.