This is a secondary school teacher who just retired a year ago. In the past month, he had three consecutive episodes of dizziness, chest tightness, breath-holding and palpitations. He was first seen at a local hospital and diagnosed with “cerebral blood supply deficiency and coronary artery disease?” He was treated with infusion, but his condition did not ease. He was referred to our emergency room, and after initial examination and infusion, he improved, and then he came to the outpatient clinic after a number of tests. I saw him at first sight: frowning, hand over chest, shortness of breath, slight sweat on forehead, pale face, moaning in mouth, weak voice, his body shape was obese, with beer belly and flabby skin muscles. I helped him to sit slowly on a chair and started the treatment. I first taught him, “Here, first learn from me, slowly do deep breathing.” He learned and gradually calmed down.
After that, I asked for further detailed medical history. He reported that he had been in poor health for a year after retirement: insomnia, fatigue, loss of appetite, bone and joint pain; frequent panic attacks, hot flashes and sweating; decreased libido, reduced impulsiveness, impotence and premature ejaculation during intercourse; mental anxiety, forgetfulness, poor concentration, fatigue, mood swings, inexplicable irritability, nameless anger, nameless fear and nervousness, and decreased self-confidence. Decline; overall quality of life is reduced. The onset of the disease started a month ago, and after treatment it has not improved and is getting worse. He was worried that he was suffering from cerebral infarction and myocardial infarction. All tests such as CT, MRI, cardiac ultrasound, and pulmonary function were done successively, but they were all normal.
After reading his medical records, no positive signs were found after neurological examination. I immediately realized that this was a male with menopausal anxiety disorder. The main factor in the occurrence of symptoms is the decline in testosterone levels in men with age. Between the ages of 30 and 90, testosterone decreases by an average of 1% to 2% per year, with a total decrease of up to 1/3 to 1/2. There is an imbalance between the testes, pituitary gland, hypothalamus and cerebral cortex, and an imbalance in the regulation of secretion by the adrenal glands, and male androgen production begins to decline, and the hypothalamus, located in the upper pituitary gland, is in an excited state. It can induce male menopause anxiety due to unhealthy lifestyle, such as smoking and alcohol abuse, chronic diseases, poor living environment, etc.
Diagnosis: Because men’s testosterone levels decline slowly and gradually, unlike women’s “menopause”, “menopause” can also occur. The diagnosis is made through blood testosterone concentration measurements, symptomatology, and the patient’s self-assessment of physical, vasodilatory, psychosomatic, sexual, and four clinical findings. This patient initially insisted on suspecting that he was suffering from cardiovascular and cerebrovascular disease and did not accept the treatment method I prompted. However, later on, when the symptoms persisted without relief, he became more anxious and had panic attacks in severe cases. He also had to call the emergency vehicle to the hospital several times. After I repeatedly explained the cause of the disease, he finally accepted my treatment advice. Testosterone undecanoate (Antel) was supplemented to make it safe and effective to treat menopausal symptoms; it was accompanied by anti-anxiety medication and behavioral therapy to regulate psycho-spiritual status.
When men enter menopause, androgens decline, libido decreases, sexual urge decreases, and impotence also occurs, and they are often full of apologies and self-blame to their wives during sexual life, and psychological pressure increases. It seriously affects the self-confidence of men. Forgetfulness, lack of concentration, mood swings, and decreased quality of life and work also occur in daily life. Male menopause usually occurs after the age of 55, and in addition to the decline in androgen levels, a series of endocrine changes occur in the body. A poor lifestyle or poor living environment is also a cause of male menopause that cannot be ignored. In addition, other diseases such as acute myocardial infarction, diabetes, renal failure, and cirrhosis of the liver may also cause androgen reduction. Also, different lifestyles indirectly affect the level of androgen in men. For example: the structure of diet, people who eat mainly vegetarian diet have high androgen level; people who eat mainly meat and fat have low androgen level; people who are chronically hungry have low androgen, smokers have lower androgen than non-smokers, and of course, alcoholics have the same. All of these bad habits can accelerate the early onset of menopause.
I counseled this patient on relaxation training. He was prompted to pay attention to the following points: the treatment room should be quiet, neat, softly lit, and in a suitable environment; sit in a chair or lie flat on the bed and make yourself as comfortable and pleasant as possible; and gently close your eyes.
[Afterwards, instruct the patient] “I will now teach you how to relax yourself. In order to relax, I will first make you tense up and then relax your whole body. The process of tensing and relaxing is designed to make you experience relaxation so that you can learn how to stay relaxed. Okay, I’ll let you experience the feeling of muscle tension first.”
I hold the patient’s wrist in my hand and prompt the patient, “Please flex your forearm hard against my pull and experience the feeling of muscle tension.” (for 10 seconds)
”Okay, please relax, try to relax and experience the difference in feeling.” (pause for 5 seconds)
”This is the basic experience of feeling and relaxation. Next I will make the muscles of your whole body gradually tense and relax, starting from the hands, followed by the upper limbs, shoulders, head, neck, chest, abdomen, lower limbs, up to the feet, in order to each group of muscle groups first tense, then relaxation exercises, and finally achieve the purpose of relaxation of the whole body.”
The relaxation procedure is as follows
Step 1: “Take a deep breath in and hold it for a while.” (Stop for 10 seconds)
”Okay, breathe out slowly, breathe out slowly.” (Pause for 5 seconds)
(Repeat once more.)
Step 2; “Now, extend your forearm, clench your fist, clench hard, and experience the feeling of tension in your hand.” (Stop for 10 seconds)
”Okay, please relax and do your best to loosen your hands and experience the feeling of relaxation. You may feel heavy, relaxed, warm, these are the feelings of relaxation, please experience this feeling.” (pause for 5 seconds)
”Let’s do it again now.” (Same as above)
Step 3: “Now, bend your arms and tense the muscles in your arms hard, hold for a moment and experience the tension in your arms muscles.” (pause for 10 seconds)
”Okay, now relax, completely relax your arms and experience the feeling after relaxation.” (Pause for 5 seconds)
”Let’s do it again now.” (Same as above)
Step 4: “Now, start practicing how to relax your feet.” (Pause for 5 seconds)
”Okay, tense your feet, tense your toes hard, tense them hard, and hold them for a moment.” (Pause for 10 seconds)
”Okay, relax, relax your feet completely.” (Pause for 5 seconds)
”Let’s do it again now.” (Same as above)
Step 5: “Now, start relaxing the muscles in your calves.” (Pause for 5 seconds)
”Please tense the muscles in your calves by pushing your toes up hard and pressing your heels down and back, hold.” (10 seconds pause)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again now.” (Same as above)
Step 6: “Now, start relaxing the muscles in your thighs.” (Pause for 5 seconds)
”Please press forward and down firmly with your heel, tensing your thigh muscles, and hold for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again now.” (Same as above)
Step 7: “Now, let’s start paying attention to the head muscles.” (pause for 5 seconds)
”Please crinkle your forehead muscles, crinkle them, crinkle them, and hold them for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Now, please squeeze your eyes shut, squeeze them hard, hold for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Now, turn your eyes, up, to the left, down, to the right, faster; okay, turn your eyes from the opposite direction, faster; okay, stop, relax, relax completely. ” (Stop for 10 seconds)
”Now, clench your teeth, clench hard and hold for a moment.” (Stop for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Now, hold your tongue against your palate for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Now, press your head back hard, hard, and hold for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Now, tighten your chin, tighten inward with your neck, hold for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again.” (Same as above)
Step 9: “Now, lift your shoulders up as close to your earlobes as you can, lift them up hard and hold for a moment.” (pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again.” (Same as above)
Step 10: “Now, tighten your shoulders inward, hard inward, and hold for a moment.” (Pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again.” (Same as above)
Step 11: “Please lift your legs upward, lift them up hard, bend your waist, bend hard, hold it for a moment, hold it for a moment.” (pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again.” (Same as above)
Step 12: “Now, please tense your gluteal muscles and lift your perineum up hard, hard, and hold for a moment.” (pause for 10 seconds)
”Okay, relax, relax completely.” (Pause for 5 seconds)
”Let’s do it again.” (Same as above)
Complete the above relaxation exercise once. After a 2 minute break, do it again from the beginning.
After the relaxation exercise I told him, “That’s the whole relaxation process. Now, feel every group of muscles in your body, from top to bottom, all over your body in a relaxed state. Your toes, feet, thighs, hips, lower back, chest, hands, shoulders, neck, jaw, eyes, and forehead. Finally, all the muscles of your body are in a relaxed state.” (pause for 10 seconds)
”Please further notice the feeling after relaxation, at this time you have a warm, pleasant, comfortable feeling, to keep this feeling for as long as possible for 1 to 2 minutes. Then please close your eyes while I count from 1 to 5. When I count to 5, open your eyes and you will have a calm, peaceful, comfortable, pleasant and refreshed feeling.” (Pause for 1 minute)
”Okay, I will start counting. 1. feel calm; 2. feel very peaceful and calm; 3. feel comfortable and pleasant; 4. feel refreshed; 5. please open your eyes.”
The above is the whole treatment procedure of relaxation training. After mastering the procedure of relaxation training, I asked him to go home and practice it by himself. Perform it 1~2 times a day for 15 minutes each time, and ask him to be consistent. Tell him: stick to it and you will definitely have good results. This treatment is applicable to patients with all types of anxiety disorders.
According to the relevant literature: 1/3 of men aged 40-70 years old are currently experiencing menopausal symptoms. Japanese studies have concluded that bank employees, teachers, architects, and business executives are the groups with the most menopausal symptoms.
There is no need to worry too much about this. First of all, you should always have a thorough physical examination to confirm the diagnosis and use of medication. Secondly, we should learn to control our emotions, not to be calculating in everything, to be open-minded, optimistic and open-minded, to be able to afford to let go; to live a regular life, to increase outdoor sports, to participate in social activities that are easy on the body and mind; to learn to relieve ourselves, to confide in our friends; furthermore, to pay attention to the diet structure, to ensure that the body must: according to the opinion of nutrition experts, men entering menopause can eat more barley, soybeans, yams, burdock The first thing you can do is to eat more of the same, such as barley, yam and sweet potato porridge for breakfast.
Here, the World Health Organization introduced the “Ten Standards of Male Health”, middle-aged and older men can learn from: 1.
1, have plenty of energy, can comfortably afford daily life and work, without excessive fatigue and tension.
2, optimism in the world, positive attitude, willing to take responsibility, things are not too concerned about their own interests.
3, good at rest, good sleep.
4, resilient, able to adapt to various changes in the external environment.
5, able to resist common colds and infectious diseases.
6, appropriate weight, proportionate body, head, shoulders and hips in a coordinated position when standing.
7, bright eyes, responsive and non-inflamed eyelids.
8, clean teeth, no teeth, no pain, normal tooth color, no bleeding
9, shiny hair, no dandruff.
10.Muscles are plump and elastic.
Thereafter, this retired teacher patient obtained satisfactory treatment results after 3 months of systematic treatment with me. I instructed him to continue to consolidate his treatment for 3 months. It has been more than two years since then, and he is in good spirits and has not had any recurrence of the disease.