About LOH

It is estimated that approximately 6 million people in Japan suffer from LOH, a condition that has been recognized globally since the early 2000s (it is sometimes referred to as LOH syndrome).

LOH is defined as “a syndrome caused by a decrease in male hormones (testosterone) associated with aging and stress.” In recent years, cases of decreased male hormone levels have been observed even in younger men (in their 20s and 30s).

Male hormones play various roles beyond just sperm production and muscle strengthening. They also affect muscles, bones, the central nervous system, the prostate, sexual function, and urinary function. When men experience LOH, these functions can be impaired, leading to a variety of symptoms as listed below.

While male hormones are often associated with “sexual desire,” they also have a significant impact on mental well-being. We frequently hear about symptoms such as “having sexual desire but being unable to sleep well” or “being told that your personality has changed and feeling an inexplicable sense of anxiety.”

To objectively assess the severity of LOH symptoms, the AMS score (Aging Males’ Symptoms questionnaire) can be used. This questionnaire allows you to evaluate your condition on a scale from 1 (no symptoms) to 5 (very severe symptoms) across various categories. By totaling your score, you can better understand the severity of your symptoms.

The AMS score is also known to be highly useful in measuring the effectiveness of hormone therapy.

[AMS Score]

For each question, rate the severity of your symptoms on a scale from 1 to 5. The total score across 17 items will help gauge the overall severity of your symptoms.

Source: Japan Urological Association / Japan Men’s Health Medicine Association “LOH Syndrome Clinical Guidelines,” and the Working Committee’s “Guidelines for Clinical Practice of Late-Onset Hypogonadism.”

Unlike female menopause, LOH does not have a defined onset period. Once male hormone levels decline, symptoms can persist for the rest of your life.

Therefore, if you are experiencing any symptoms that concern you, we recommend undergoing a thorough examination.

Diagnosis and Treatment Process

Our LOH Clinic offers treatment tailored to each patient’s condition through the following three steps:

Counseling and Testing

If you suspect you have symptoms of LOH or wish to be tested, you can undergo a detailed examination following a consultation with one of our doctors.

During the LOH testing, STI screening is also available at a special rate.

We also offer consultations for those who are already undergoing treatment but are concerned about their future treatment options.

Diagnosis and Treatment

Based on the test results, we will diagnose LOH. According to current guidelines, treatment eligibility is determined not only by blood test values but also by considering the severity of the patient’s symptoms.

In the past, short-acting testosterone preparations were commonly used to treat LOH. However, due to the extremely unstable supply of short-acting testosterone preparations and the significant fluctuations in hormone levels after administration, which often lead to side effects, this approach has posed challenges.

Regular Tests and ED Treatment Associated with Hormone Therapy

After starting hormone replacement therapy, we regularly check testosterone levels and monitor changes in symptoms to ensure that treatment continues safely.

ED medications are also considered effective in treating LOH, as they can help improve erectile dysfunction and sexual function and may also contribute to increasing testosterone levels.

We offer consultations and treatment for ED for those who are interested.

Testing for LOH

Diagnosis of LOH involves checking whether the levels of “free testosterone” and “testosterone” meet the standard values and whether other conditions, particularly lifestyle diseases, might be contributing to the decline in male hormones.

We offer a comprehensive range of tests necessary for diagnosing LOH, starting at 10,000 JPY for the initial visit.

Additionally, PSA testing, a tumor marker for prostate cancer, is recommended when undergoing hormone therapy. This is because beginning male hormone therapy in individuals who already have prostate cancer can accelerate the progression of the disease. (There is no evidence that male hormones cause prostate cancer, but it is dangerous for those who already have it to start hormone therapy.)

We recommend PSA testing for individuals concerned about prostate cancer or those of an appropriate age. The additional cost is only 2,000 JPY.

We also offer STI screening at a special price of 10,000 JPY (otherwise 24,000 JPY) during the LOH testing, so please take advantage of this opportunity.

Lifestyle Improvements

Lifestyle improvements include changes in diet, exercise habits, workplace environment, and personal relationships. However, some of these may be difficult to improve immediately.

Many individuals with LOH feel a decline in physical strength or lack the motivation to make lifestyle changes (which is itself a symptom of the syndrome). In such cases, considering the initiation of testosterone therapy may be beneficial.

Testosterone Therapy

There are three methods of testosterone supplementation: injections, oral medications, and topical applications. Our clinic offers all of these options.

The Nebido generic oral medication allows for effective and safe testosterone supplementation with just one tablet per day. It is convenient, affordable, and easy to continue.

Additionally, the dosage can be gradually adjusted according to the patient’s symptoms, allowing for a smooth and manageable treatment process by monitoring hormone levels and making necessary adjustments.