"I just can't shake off the fatigue lately." "I don't feel as motivated to work or pursue my hobbies as I used to."
Some people in their 40s may be experiencing unexplained fatigue and a decline in energy. These symptoms may not only be due to a lack of energy or age, but may also be a sign of male menopause.
Although menopause is often thought of as something that only affects women, men can also experience similar physical and mental discomfort due to hormonal changes.
In this article, we will explain in detail the symptoms of LOH syndrome, which is the true nature of male menopause, as well as the differences between it and female menopause and treatment methods.
table of contents
What is male menopause?
Male menopause is a general term for various physical and mental symptoms caused by a decline in the level of male hormone (testosterone), primarily due to aging and stress. It is also known as LOH syndrome (Long-Term Male Hypogonadism Syndrome), but the timing and degree of the decline in testosterone vary greatly from person to person.
There are no epidemiological studies investigating the frequency of this condition in Japan. However, it has been reported that the percentage of men with low testosterone levels is approximately 10% in their 40s, approximately 20% in their 50s, and approximately 50% in their 60s. Although the number of people diagnosed with LOH syndrome is smaller than this, it is certainly not something that only affects other men.
source:Japanese Urological Association and Japan Men's Health Medical Society "LOH Syndrome Treatment Guidelines"
Symptoms of male menopause
Symptoms of male menopause are extremely diverse, ranging from psychological to physical and sexual issues, and it is not uncommon for multiple symptoms to appear at the same time.
| site | symptoms |
|---|---|
| Neuropsychiatric symptoms | Fatigue, depression, various anxieties, insomnia, loss of appetite, difficulty concentrating, etc. |
| physical symptoms | Cardiovascular system: hot flashes, flushing, cold hands and feet, palpitations, sweating, etc. Sensory system: headache, dizziness, tinnitus, numbness in the hands and feet, etc. Musculoskeletal system: muscle weakness, decreased athletic ability, etc. |
| sexual function symptoms | Loss of sexual desire, erectile dysfunction (ED), etc. |
Unlike women, men do not have a clear menopause milestone, so it can be difficult for men to realize that their symptoms are due to menopause.
source:Fujita Health University Department of Urological Surgery "Male Menopause in the Spotlight"
The difference between male and female menopause
Male menopause and female menopause are both caused by a decline in sex hormones, but there are significant differences in how they manifest.
The biggest difference is the timing and duration. Women experience a rapid decline in hormone levels after menopause around age 50, but for men, there is no set time and it can continue indefinitely after their 40s.
| andropause | female menopause | |
|---|---|---|
| cause | Decrease in male hormones | Decline in female hormones |
| season | Not decided yet (forever after 40) | Five years before and after menopause (around age 50) |
| period | There's no end | Symptoms subside about 5 years after menopause |
A characteristic of male menopause is that there is no clear end.
source:Japan Endocrine Society "Male menopause (age-related hypogonadism, LOH syndrome)"
Testing and treatment for LOH syndrome
Here we will explain the testing methods and treatments for LOH syndrome.
Testing methods for LOH syndrome
If you have any symptoms that concern you, consult a specialist medical institution such as a urologist or men's health clinic. Diagnosis is mainly made by a doctor's interview and blood tests to measure testosterone levels.
medical interview
In addition to doctors directly asking about symptoms, specialized questionnaires may be used to more objectively assess the severity of symptoms. A typical questionnaire is the Aging Males' Symptoms (AMS) score, which has been translated into many languages, but there are also questionnaires developed for Japanese people.
However, LOH syndrome cannot be diagnosed based on a medical interview or questionnaire alone. Questionnaires are used solely to assess the severity of symptoms and confirm the effectiveness of treatment.
Testosterone measurement
Blood tests measure the levels of free testosterone (FT) and total testosterone (TT), which are active in the body, and make a comprehensive diagnosis. LOH syndrome can occur when only FT is low, or when both FT and TT are low.
If both testosterone levels are low but the luteinizing hormone (LH) secreted by the brain is not elevated, other underlying factors such as obesity or type 2 diabetes should be carefully investigated.
Treatment for LOH syndrome
Treatment for LOH syndrome involves lifestyle changes, symptom management, and testosterone replacement therapy, depending on the symptoms.
improvement of lifestyle
The basis of treatment is a review of lifestyle habits. Symptoms may improve by getting enough sleep, eating a balanced diet, and exercising moderately. If symptoms do not improve even after reviewing lifestyle habits, Chinese herbal medicines such as Hochuekkito, which replenishes the vitality of the entire body, may be prescribed.
Symptom management
Individual symptoms may be treated with medication. For example, erectile dysfunction medications are used to treat decreased sexual function, antidepressants and anti-anxiety medications are used to treat severe depression and anxiety, and osteoporosis medications are used to treat declining bone density.
Testosterone replacement therapy
If blood tests show that testosterone levels are clearly low and symptoms are severe, testosterone replacement therapy is performed to directly replenish the decreased testosterone. In Japan, the only treatment covered by insurance is intramuscular injection of testosterone preparations. Intramuscular injections of testosterone are administered every 2 to 4 weeks until symptoms improve.
source:Japanese Urological Association and Japan Men's Health Medical Society "LOH Syndrome Treatment Guidelines"
source:Japan Endocrine Society "Male menopause (age-related hypogonadism, LOH syndrome)"
summary
The physical and mental discomfort experienced by men in their 40s and beyond may not simply be due to energy or age, but may be due to a clear medical reason: a decline in testosterone. Just like women going through menopause, men also go through a period when they must deal with changes in their sex hormones.
With proper testing and treatment, men experiencing menopause can regain their vitality and confidence and lead energetic lives. If you feel like something is a little off, don't keep it to yourself; consult a specialist.