Many people know that women have menopause, but few people know that men also have menopause, only that some patients have less obvious symptoms, so they are often ignored. The mechanism of male menopause is still unclear, but most scholars believe that the mechanism of male and female menopause is similar. In men, it is mainly due to the atrophy of the testes, the decrease of testosterone secretion, the increase of the secretion function of the pituitary gland stimulated by feedback, the decrease of the response of the atrophied testes to gonadotropin, the imbalance of the regulation function of androgens in the body, and the gradual decrease of androgen (testosterone) secretion, resulting in a series of clinical This leads to a series of clinical symptoms. The onset of male menopause is late, and the time of appearance is very inconsistent. The age of onset is usually around 50-65 years old, and there are a few cases of onset around 45 years old. The clinical manifestations of menopause vary from mild to severe, even unnoticed in mild cases, to severe cases affecting life and work, and patients feel very painful.
A. The clinical manifestations of male menopause are generally seen in the following symptoms.
1, mental symptoms.
Mainly temperament change, such as depressed mood, less active and lazy, sad and sentimental, sullen and want to cry, or nervousness, hypersensitivity, anxiety, moody and unpredictable, or random thoughts, catching the wind, lack of trust, etc., and in serious cases, even the idea of light life.
2. Cardiovascular system symptoms.
Such as palpitations and palpitations, precordial discomfort, or self-reported precordial pain, or dizziness and tinnitus, baking heat and sweating.
3, digestive system symptoms.
Such as loss of appetite, nausea and vomiting in severe cases, abdominal distension, constipation, abdominal pain and discomfort, etc.
4, neurasthenia performance.
Such as insomnia, sleeplessness and dreaminess, easy to wake up, memory loss, forgetfulness, slow reaction, fatigue and weakness, dizziness and headache, etc.
5, sexual dysfunction.
Commonly, decreased sexual desire, impotence, premature ejaculation, low semen volume, etc.
6, physical changes.
The muscles of the body start to loosen, the subcutaneous fat is richer than before, the body becomes fatter, and shows a “blessed” look.
Laboratory test: Hormone six test indicates that plasma free testosterone is lower than normal or close to the lowest value.
Second, male menopause syndrome should be distinguished from the following diseases, do not delay the treatment of the disease because of suspicion of menopause syndrome.
1, mania and depression.
Mania is often preceded by fatigue, irritability, impatience, severe insomnia, long-standing high mood, often accompanied by increased language movements and exaggerated thinking content, etc. Depression has more indifference, insomnia, fatigue, loss of appetite, prolonged depression, etc. These two diseases have an early age of onset, and the initial age of onset is mostly in young adulthood. If the patient happens to be a middle-aged male, it is recommended to consult a psychiatrist and a male specialist for joint treatment by the two doctors.
2. Hypertensive disorders.
It can occur at any age, especially in people over 40 to 50 years old. Most of them visit the doctor with headache and dizziness symptoms, and their blood pressure is higher than normal when measured several times. Mostly accompanied by a family history. Without the application of antihypertensive drugs, it is difficult to reduce blood pressure to normal.
3. Diabetes mellitus.
Some adult type diabetes can occur after 45 years of age, and is more common in obese people, and can have weakness, loss of libido, back and leg pain, itchy vulva, etc. Many people with “three more and one less” symptoms are not obvious, and can be judged according to fasting blood sugar, glucose tolerance test, glycated hemoglobin and other test results.
4. Gastrointestinal diseases.
Patients generally show symptoms such as loss of appetite, abdominal discomfort or pain, diarrhea, constipation, nausea and vomiting. Gastroscopy, colonoscopy and other tests are needed to further identify. Such diseases require the cooperation of gastroenterologists for diagnosis and treatment.
5. Heart disease.
There are symptoms such as palpitations, dizziness, a feeling of suffocation in the precordial region, pain in the precordial region, etc. Electrocardiogram and cardiac ultrasound can be identified. If it cannot be clearly identified, coronary artery CTA and coronary angiography may be used to further identify coronary artery disease.
6. Intracranial diseases.
For middle-aged men with dizziness and headache as the main complaints, not only hypertension should be excluded, but also cerebrovascular diseases, such as cerebral insufficiency of blood supply, cerebral hemorrhage, cerebral infarction, intracranial occupancy and other diseases may appear dizziness and headache, and cranial CT and MRI should be checked for differentiation. Neurologist is needed to cooperate with the differential diagnosis and treatment.
7. Cervical spondylosis.
Patients with cervical spondylosis may also have dizziness and headache, but they are usually accompanied by symptoms of neck and shoulder pain, or in severe cases, nausea, vomiting, or even numbness of the upper limbs. Cervical spine films need to be checked.
8, thyroid disease.
Hyperthyroidism is mainly based on a high metabolic state, with clinical signs of excitement, sweating, panic, poor sleep, and hyperphagia; hypothyroidism is mainly based on a low metabolism, with indifferent expression, chills, poor appetite, fatigue and weakness, and even swelling around the body. It is necessary to check the five items of thyroid function and thyroid ultrasound to identify.
Treatment of male menopause.
Western medical treatment.
Testosterone supplementation is a very effective treatment clinically. Testosterone treatment can improve total health status and mood, improve libido, increase muscle strength and bone mineral density. The more desirable drugs available are oral testosterone analogues. Many clinical studies have reported and real-life medical records prove this. Exogenous testosterone does not penetrate the blood-testis barrier to affect the function of the testes themselves. Long-term application of a large amount of testosterone causes testosterone to reach a certain level in various tissues in the body, thus inhibiting the secretion of luteinizing hormone, which will feedback to inhibit the secretion of testosterone in the testes and affect the normal function of the testes. In severe cases, testicular atrophy or even disappearance occurs. It is common to see patients with testicular atrophy due to long-term application of testosterone in the clinic. Long-term application of testosterone increases the incidence of prostate cancer and increases the symptoms of patients with prostate enlargement. It increases the risk of vascular embolism and increases the incidence of cardiovascular disease due to affecting lipid metabolism and increasing blood cell pressure, and can worsen the condition of patients with respiratory sleep apnea syndrome. Therefore, a professional male physician is needed to guide the medication. For patients with low laboratory serum testosterone can be supplemented with testosterone for a short time to improve clinical symptoms. Before applying testosterone, the patient’s condition should be evaluated, whether the patient is at risk of developing cardiovascular and cerebrovascular diseases, whether the patient has the presence of respiratory sleep apnea syndrome, men over 45 years old must be tested for prostate-specific antigen (PSA) to discharge the possibility of prostate cancer, and patients with prostate enlargement should weigh the pros and cons and must grasp that the benefits outweigh the disadvantages before applying.
Chinese medicine treatment.
The Chinese medicine believes that male menopause is the stage of “seven or eight liver qi decay, tendons can not move, the sky is depleted, less essence, kidney hide decay, the form is extreme, eight or eight is the hair of the teeth”, kidney qi gradually decay, essence and blood increasingly insufficient, resulting in kidney yin and yang disorder, because kidney yin and kidney yang is the root of the internal organs yin and yang, the kidney yin and yang disorder and then lead to the internal organs function disorder This leads to the pathological basis of male menopause syndrome. In addition, heart yin or heart yang deficiency can occur due to excessive strain on the heart. If the disease is prolonged, liver-yin deficiency and spleen-kidney deficiency will occur.
The following clinical patterns are mostly seen.
1. Kidney Yin deficiency.
Wasting of the body, hot flashes and night sweats, dry throat, heat in the hands and feet, tinnitus and deafness, dizziness, memory loss, soreness and weakness of the waist and knees, diminished sexual function, red tongue with little coating, buy fine count. Chinese medicine can be used Liu Wei Di Huang Wan, Zhi Bai Di Huang Wan, etc.
2, kidney Yang deficiency.
Mental depression, cold in the extremities, soreness and weakness of the waist and knees, coldness of the penis or testicles, decreased libido, impotence and premature ejaculation, clear and long urine or loose stools, light and fat tongue, sunken and weak pulse. Chinese medicine can be used Jin Kui Kidney Qi Pill, Ji Sheng Kidney Qi Pill, etc.
3. Heart and kidney disorder.
Restlessness, forgetfulness and dreaminess, soreness and weakness of the waist and knees, spermatorrhea, feverishness of the five hearts, night sweating, red tongue with little coating and thin pulse. The Chinese medicine can be chosen from Tianwang Tonic Heart Pill and Jiaotai Pill.
4.Spleen and kidney Yang deficiency.
Obesity, white face, fatigue, cold body and cold limbs, poor appetite, thin stool, or abdominal distension, fat tongue, thin white or greasy moss, sunken and weak pulse. The Chinese medicine can be selected from Ginseng Jianquan Pill and Alloy Kui Kidney Qi Pill.
5.Liver qi stagnation.
Chest tightness and discomfort, irritability or depression, insomnia and dreaminess, irritability, red tongue, yellow moss and string pulse. The Chinese patent medicine can be used Chai Hu Dredging Liver San, Prosperity Pill, Plus Flavor Prosperity Pill, etc.
The treatment of proprietary Chinese medicines should not be chosen indiscriminately, but should be applied under the guidance of Chinese medicine practitioners, otherwise it will be counterproductive.
Fourth, pharmacotherapy and dietary care:
1. Heart and kidney disorder type.
Gui Yuan Lily Porridge: 30 grams each of longan meat and lily, 6 jujubes, 100 grams of rice, the right amount of rock sugar, cooked as a porridge, morning and evening to take.
Lean pork, lotus seeds and lily soup: 250 grams of lean pork, 30 grams of lotus seeds and 30 grams of lily, boiled with water into soup, seasoned and eaten once a day.
2. Kidney Yin deficiency type.
Xuan Di Wu Chicken Soup: 9 grams of Xuan Ginseng, 15 grams of raw earth, 500 grams of black-bone chicken. Remove the guts of the chicken, put the ginseng and raw earth in the chicken belly sewn firmly, add water and stew, seasoning and then eat.
3, spleen and kidney Yang deficiency type.
Walnuts and lotus seeds porridge: 20 grams of walnuts, 18 grams of lotus seeds, 18 grams of gorgonians, 60 grams of rice, cooked into porridge, seasoned and eaten.
Goji berry and mutton soup: 15 grams of goji berries, 18 grams of chestnuts, 60 grams of mutton, wash and cut the mutton into pieces, put all the ingredients into a pot and stew, season and eat.
Eat more food rich in protein, calcium and a variety of vitamins, pay attention to reasonable nutrition; chicken and fish, rabbit meat is easy to absorb, can be appropriate to eat; beans and their products in the plant protein, is the body must be the “warehouse” of trace elements; fresh vegetables can provide Dali vitamins, should be the main menu. The food to improve enhance gonadal function are: shrimp, mutton, sparrow, sheep kidney, leek, etc. You can use lamb meat cistanche porridge, eucommia burst lamb waist, cordyceps casserole duck, shrimp fried leek, walnuts fried leek, a product yam, etc.
Five, male menopause syndrome preventive care.
1, life conditioning.
Strengthen exercise, enhance physical fitness, improve the body’s ability to adapt, regular living, room and board, in order to maintain the kidney essence, light diet, care for the spleen and stomach, quit smoking and alcohol, Shu adjust the mood, reduce anxiety, and smooth the qi and blood.
2.Dietary regulation.
In the identification and treatment, dietary conditioning should not be neglected, because the pathogenesis of male menopause syndrome is the deficiency of kidney essence, so the diet should be used to nourish the role of kidney essence, while the diet should be light, easy to digest, less fried fatty and sweet products, avoid spicy stimulating diet.
3, spiritual conditioning.
Strengthen ideological training, often maintain optimism, overcome psychological tension factors, establish a firm belief in life, and exercise perseverance.
Although male menopause syndrome has more clinical symptoms, the root of the disease is a series of symptoms caused by the reduction of androgen secretion, as long as the patient’s condition is properly adjusted, supplemented by positive psychological guidance, can safely pass through this period, but there are a few patients due to the gradual increase in symptoms, can cause more serious organic disease, we must pay sufficient attention.