Have you been feeling severely tired, unmotivated, without sexual desire, or unable to sleep lately? It may be male menopause (late-onset hypogonadism) (LOH syndrome).

We provide specialized consultations for male menopause (late-onset hypogonadism) (LOH syndrome: Late-Onset Hypogonadism, pronounced “loh” syndrome).

For a detailed explanation of male menopause (late-onset hypogonadism), please see the blog post below.

Male menopause (late-onset hypogonadism) has attracted worldwide attention in recent years, but in Japan the term itself is not widely recognized, and people who need treatment are not able to receive satisfactory care. Recently there have also been cases of people in their 20s to 30s being treated under a diagnosis of male menopause (late-onset hypogonadism).

With a certified testosterone treatment physician, you can discuss appropriate hormone treatment and future plans together with us, so please feel at ease.

You can check whether you may have Late-Onset Hypogonadism from the link below.

If you have any questions about Late-Onset Hypogonadism (LOH) care, please contact us through our official LINE.

Please select the section to jump to.

What is male menopause (late-onset hypogonadism)?

Male menopause (late-onset hypogonadism) is said to affect approximately six million people in Japan, and it is a condition that began to be pointed out worldwide from the early 2000s (it is now sometimes described as LOH syndrome).

Male menopause (late-onset hypogonadism) is defined as “a syndrome caused by a decline in male hormone (testosterone) associated with aging and stress”, and in recent years cases of declining male hormone have also been seen in younger people (such as those in their 20s to 30s).

Male hormone has a wide range of functions — not only sperm formation and muscle strengthening but also muscle and bone, the central nervous system and the prostate, sexual function and urinary function, etc. When male menopause (late-onset hypogonadism) develops, these are impaired and various symptoms such as the following appear.

Male hormone may be easily linked with “sexual desire”, but it in fact acts strongly on mental aspects as well, and we often hear symptoms such as “I have sexual desire, but I cannot sleep well” or “People say my personality has changed, and I constantly have an indescribable feeling of anxiety”.

To assess the severity of Late-Onset Hypogonadism symptoms in detail, using the AMS score (the male menopause (late-onset hypogonadism) questionnaire) lets you understand your own condition objectively as a score, so rate the questions below from 1 point (symptom: none) to 5 points (symptom: extremely severe) and work out your total.

The AMS score is also known to be a very useful questionnaire for measuring the effect of hormone treatment.

You can check whether you may have Late-Onset Hypogonadism from the link below.

[AMS Score]

For each answer, assign 1 to 5 points according to the severity of the symptom. The total of the 17 items indicates the degree of symptoms.

Source: The Japanese Urological Association / The Japanese Society for Men’s Health, “Clinical Practice Guidelines for LOH Syndrome”; Working Committee, “Clinical Practice Manual for Late-Onset Hypogonadism”

Unlike menopause in women, male menopause (late-onset hypogonadism) has no fixed time of onset, and once a hormone decline occurs the symptoms may continue throughout your life.

For this reason, if you have symptoms that concern you, we recommend having testing first.

Diagnosis and Treatment Process

For Late-Onset Hypogonadism, we can provide treatment tailored to each patient’s individual condition through the following 3 steps.

Counseling and Testing

If you suspect symptoms of male menopause (late-onset hypogonadism) or wish to have testing, you can undergo detailed testing after a doctor’s consultation.

At the time of testing for male menopause (late-onset hypogonadism), a full set of STI testing is also available at a special price.

We also accept treatment consultations from those already under treatment who have concerns about their future care.

Diagnosis and Treatment

We diagnose male menopause (late-onset hypogonadism) based on the test results. Current guidelines specify that eligibility for treatment be judged by considering not only blood test values but also the patient’s severity, etc.

Conventionally, short-acting male hormone preparations were commonly used for male menopause (late-onset hypogonadism). Recently, however, the supply of short-acting male hormone preparations has been extremely unstable, and blood hormone levels fluctuate greatly after hormone administration, so side effects from hormone administration also tend to occur — and this has been a problem.

Regular Testing Accompanying Hormone Therapy and
ED Treatment

After starting hormone replacement therapy, you can continue treatment safely while regularly checking testosterone values and changes in symptoms.

ED medication is also said to have a therapeutic effect on male menopause (late-onset hypogonadism) itself, and it is effective not only for those with erectile dysfunction or reduced sexual function but also for those who want to raise their testosterone values.

For those who wish, we can also provide consultation and treatment for ED.

Testing for male menopause (late-onset hypogonadism)

To diagnose male menopause (late-onset hypogonadism), we check whether the “free testosterone” and “testosterone” values meet the reference values, and whether male hormone may be lowered by other conditions, mainly lifestyle-related diseases.

At our clinic, the first time you can comprehensively examine the various tests needed to diagnose male menopause (late-onset hypogonadism) for 10,000 yen (tax included).

PSA, a tumor marker for prostate cancer, is recommended for testing when hormone therapy is carried out.

This is because starting testosterone therapy in someone who already has prostate cancer would advance the condition. (There is no fact that male hormone causes prostate cancer. It is dangerous when someone who already has it starts hormone therapy.)

We recommend PSA testing for those concerned about prostate cancer and according to age group. The additional cost is only 2,000 yen (tax included).

We also offer STI screening tests at a special price at the time of testing for male menopause (late-onset hypogonadism) (10,000 yen, tax included; normally 24,000 yen), so please make use of it.

Treatment for male menopause (late-onset hypogonadism)

Treatment for male menopause (late-onset hypogonadism) can be broadly divided into 3 approaches: “lifestyle improvement”, “testosterone therapy” and “ED medication”.

Lifestyle Improvement

Lifestyle improvement includes improving diet and exercise habits, the workplace environment and personal relationships, etc., but we imagine that many of these cannot be improved right away.

In addition, many people with male menopause (late-onset hypogonadism) feel a decline in physical strength, or find that the motivation to change their lifestyle does not come (this is precisely what can be called a symptom of male menopause (late-onset hypogonadism)), so it is worth also considering starting testosterone therapy.

Testosterone Therapy

Testosterone therapy, which supplements male hormone, comes in 3 forms — “injection”, “medication (oral)” and “topical ointment” — and we handle all of these dosage forms.

Nebido generic is characterized by supplementing male hormone effectively and safely, requiring little effort, being inexpensive and being easy to continue.

Also, because the dose can be increased or decreased little by little according to the patient’s symptoms, treatment can be advanced gradually and without strain while monitoring hormone values.

Testosterone therapy is a highly safe treatment, but the following side effects have been reported.

At our clinic, in addition to checking for such side effects, we can provide treatment with side effects kept as low as possible by optimizing the hormone dose based on hormone values.

By carrying out a continuation blood draw set (3,000 yen, tax included) every 3 months, we assess the effect of hormone therapy and propose the optimal treatment for your hormone values.

For those who wish, blood draws for lifestyle-related diseases, etc. can also be carried out.

ED Medication

ED medication is known to be highly effective for people with male menopause (late-onset hypogonadism) who have erectile dysfunction, etc.

In addition, recent research has shown that taking ED medication not only improves ED but also raises blood testosterone values, so it is considered applicable to people with male menopause (late-onset hypogonadism) who do not have erectile dysfunction.

Since our opening, we have provided a variety of ED medications matched to patients’ needs, so please consult us with peace of mind.

How to choose an ED medication is explained in detail in the blog post below.

Daily Therapy with ED Medication

By taking a small amount of tadalafil every day (usually 2.5 to 5 mg) to stabilize the blood concentration, it is possible to obtain the effect of ED medication “at any time” without worrying about the timing of intake.

In addition to stably supporting the onset and maintenance of erections, in those who have ED plus urinary problems (such as benign prostatic hyperplasia), improvement of urinary symptoms can also be expected.

Prices

Self-pay prices are calculated with the pricing system below.

Consultation Fee

The consultation fee differs between a first visit and a follow-up visit.

If you have visited us even 1 time before, whether under insurance or self-pay, the follow-up visit fee applies.

Testing Fee

Testing fees are as follows.

[At the first visit]

[After starting hormone therapy]

^*The number of days for reporting test results is a guide counted from the “testing start date”. For samples taken after the evening of the day itself, or on Sundays, public holidays and the year-end and New Year period, the next business day becomes the “testing start date”. In the case of self-pay, results can be checked by email.

Treatment Fees

The cost of hormone therapy is as follows.

^*The cost of hormone measurement is included.

^**The amount used and the amount prescribed differ according to each patient’s individual situation. Please consult with a doctor at the time of your consultation for details.

^***For 1UP Formula, you pay a self-pay prescription fee of 2,200 yen (tax included) at our clinic, and pay the medication cost separately at a specialized pharmacy (approx. 12,100 yen).

How to Visit for Late-Onset Hypogonadism

Late-Onset Hypogonadism (LOH) care, like our other departments, is on an appointment-priority basis.

Visiting directly is expected to involve a long wait, so please make an appointment and fill in the medical questionnaire in advance.