Lack of motivation and tiredness…may be menopause
Lack of motivation, loss of concentration, and tiredness…” Such complaints may be caused by “menopause. Menopause is often the cause of such complaints. Not only women but also men experience menopausal symptoms.
says Dr. Kazuhito Matsushita, associate professor at Juntendo University Graduate School of Medicine. Many patients come to the “Men’s Health Outpatient Clinic of the Department of Urology,” where Dr. Matsushita sees patients with these symptoms who have seen a psychosomatic medicine doctor with no improvement and are wondering if they might be suffering from menopausal symptoms.
Women would first suspect menopause if they had these symptoms, but for men, there is little knowledge or information about menopause, and it is difficult to make a “connection” with menopause.
Menopause in men is similar to the decrease in female hormones that occurs in women. Men in their late 30s, 40s, and 50s naturally experience a rapid decrease in testosterone, the male hormone. This causes a variety of This causes a variety of problems. While the timing of menopause in women is generally around menopause, it is difficult for men to be aware of it, which is another reason why it is difficult to get treatment. I see a wide range of patients at my outpatient clinic, from those in their 30s to those in their late 70s.
Testosterone is a hormone that also affects motivation, judgment, and decisiveness. If you experience early morning erections or lack of motivation for even your favorite hobbies, you may be going through menopause. However, many people visit a psychosomatic medicine or mental health clinic because they are suffering from mental disorders.
Thirty percent of those who come to our clinic have already been seeing a psychosomatic medicine specialist for several months to several years before coming to us.
Hormone Replacement Therapy Improves Symptoms in 70-80% of Patients
If menopause is caused by a decrease in testosterone, then measuring testosterone levels will tell us if we are in menopause or not. If you know you are perimenopausal, can you get effective treatment?
However, it is not that simple. There are individual differences in testosterone levels, and although we have established a standard value, there are some people who complain of illness even if their testosterone levels are higher than the standard value, and on the other hand, there are people who are active and healthy even if their testosterone levels are lower than the standard value.
The values are for reference only. The presence or absence of symptoms is an important factor in making a decision.
For those with symptoms, we administer testosterone. We give them testosterone once a month for about three months to see if their symptoms improve. If the symptoms improve, it means that the symptoms were caused by a lack of testosterone.
According to Dr. Matsushita, 70 to 80% of patients’ symptoms improve with hormone replacement.
However, for those who have been seeing a psychosomatician or mental health clinic before, the possibility of menopause does not mean that they no longer need to go to a psychosomatician. It is important to take care of both sides of the equation.”
The Mechanism of Male Hormone Decrease
Women lose female hormones with menopause, but when and why do male hormones decrease?
There are various causes. One cause is stress. People in their 40s and 50s who are going through menopause have increased responsibilities at work, and they also have to worry about caring for their parents and raising children. Also, they may Many people gain weight and develop lifestyle-related diseases. People with diabetes and those with high levels of visceral fat have low testosterone levels. In fact, it could be either that they have low testosterone, which makes them prone to visceral fat, or conversely, that they have low testosterone because they have visceral fat…either way, it is possible. Such people must first change their lifestyle. Eat a well-balanced diet and exercise moderately. If they can get to an appropriate weight, there will be less need to supplement male hormones. Improving one’s lifestyle is a very effective way to combat menopause.”
If you no longer have early morning erections, you may be going through menopause. See a doctor.
An important factor in determining whether a man is perimenopausal is the presence or absence of early morning erections.
When we talk to patients who come to our clinic because they feel tired or lack motivation, we often find that they do not have early-morning erections.
They may not be able to get up in the morning, or their morning erections become weak…but they may leave it alone, saying that they are too old or too tired to do anything about it.
It is dangerous to neglect it because it is difficult to talk about it with others. Menopause in men is medically called LOH syndrome. In Japanese, it is translated as ‘age-related male hypogonadism. The loss of early morning erections is a sign that male hormones are decreasing. If your morning erection becomes weaker, I would suspect that your male hormones are decreasing and hope that this will trigger a medical examination.”
If left untreated, the symptoms may progress, requiring time off work or causing depression. If you stop getting up in the morning, it is better to deal with the problem as soon as possible.
Arteriosclerosis starts from the penis.
Based on his extensive clinical experience, Dr. Matsushita warns, “There are some symptoms that are even more worrisome.
If your testosterone levels are low and you don’t have early morning erections, but you can still have sex when you want to, you’re doing fine. However, if they are no longer useful when the time comes, it is a sign that arteriosclerosis has begun.
Many of the male patients hospitalized for stroke or myocardial infarction had ED (erectile dysfunction) five to ten years before the onset of their stroke or myocardial infarction, he said.
The first symptom of arteriosclerosis, which can cause stroke, appears in the penis. Arteriosclerosis is caused by the formation of bumps called plaques in blood vessels. This causes the blood vessels to narrow and blood flow to slow down. Its symptoms tend to come from small blood vessels. There is a concentration of small blood vessels in the penis, and blood collects there to cause an ‘erection,’ so the penis is the first to show symptoms.”
Not only will you not be able to get an erection, but you will have a life-threatening disease five or ten years down the road…. If this is the case, it is only natural that it is better to treat it as soon as possible. It is “dangerous” to rely on “temporary fixes” such as Viagra. I had no idea that the inability to get an erection could be a sign of atherosclerosis. Men’s unique signs of health may be lucky, depending on your point of view.
If left unchecked, men’s menopause can be life-threatening. It is important to check your health once without being shy.
LOH Syndrome Self-Checklist
(1) Decreased libido
(2) I feel as if I have lost energy.
(3) Decreased stamina or staying power
(4) I have become shorter.
(5) I feel like I have less fun every day.
(6) I feel sad or angry. (6) Feeling sad or angry
(7) Weak erections.
(8) Lately, I feel as if my mobility has decreased.
(9) I sometimes doze off after dinner.
(10) Lately, I am not doing well at work. (10) I feel as if my ability to do my job has decreased.
（If both (1) and (7) apply to you, or if 3 or more of the 10 items apply to you, you may be suffering from male menopause. Do not hesitate to see a doctor!
Kazuhito Matsushita Dr. Matsushita Dr. Matsushita is a specialist in the field of urology and urologic medicine. He studied at Memorial Sloan-Kettering Cancer Center in the U.S. for 3 years from 2009 as a researcher. After returning to Japan, he worked as a researcher at the Memorial Sloan-Kettering Cancer Center in the United States. After returning to Japan, he joined the Department of Urology at St. Luke’s International Hospital. Currently, he is a member of the Department of Urology, Juntendo Medical School, Juntendo University School of Medicine. He is currently in charge of the “Men’s Health Outpatient Clinic” at the Department of Urology, Juntendo Medical School, Juntendo University School of Medicine. He has performed robotic endoscopic surgery for prostate cancer and bladder cancer, and endoscopic surgery for prostatic hyperplasia. He also performs robotic endoscopic surgery for prostate and bladder cancer, endoscopic surgery for benign prostatic hyperplasia, artificial urinary sphincter implantation for abdominal pressure urinary incontinence, and men’s health (men’s medicine). Men’s health (men’s medicine): menopausal disorders associated with low testosterone levels, ED and other sexual dysfunctions. He also specializes in men’s health (men’s medicine), including menopausal disorders associated with low male hormone levels and sexual dysfunction, especially ED.
Interview and text： Izumi Nakagawa