Introduction of treatments for middle-aged chronic fatigue patients at the Korean Menopause Society
Entered 2023.12.13 18:10 Views 192 Entered 2023.12.13 18:10 Modified 2023.12.13 17:07 Views 192
People who experience menopausal syndrome as they enter middle age feel chronic fatigue and their overall body function declines even though they do not have a specific disease. [사진=게티이미지뱅크]There are many people who experience menopausal syndrome as they enter middle age. Usually, women’s menopause is the focus of attention, but men also experience chronic fatigue and overall body function declines when they go through menopause, even if they do not have a specific disease. Even after going to the hospital, many people are unable to find any solution and complain of considerable stress and pain.
The Korean Menopause Society introduced various treatment options for menopausal patients suffering from chronic fatigue at the fall academic conference held on the 10th.
In case of ‘decreased sexual function’, testosterone treatment is required after hormone test.
Male menopausal syndrome can be diagnosed when a person experiences at least two of the following symptoms due to menopause: physical changes, mood changes, and decreased sexual function, and the testosterone concentration in the blood is low in a comprehensive testosterone (TT) test.
There are some things to keep in mind when doing hormone testing. Professor Kim Young-sang of the Department of Family Medicine at Bundang CHA Hospital focused on treatments related to male menopausal syndrome and also mentioned precautions during examination.
Testing for male hormones must be done in the morning, and avoid periods of high stress. This is because testosterone secretion and blood concentration have a significant impact on sleep and stress. Therefore, the hormone concentration is highest in the morning immediately after sleep, and the blood concentration gradually decreases as the evening progresses, making it difficult to obtain accurate test results. Likewise, if the test was taken during a stressful time, a retest may be necessary.
Treatment for male menopausal syndrome involves hormonal treatment using testosterone injections for 6 months to 1 year. The goal is to maintain the blood testosterone concentration at 500 to 700 ng/DL (nanogram per deciliter) by reexamination every month or once every three months.
During the treatment process, supplementing with nutrients such as arginine, which produces nitric oxide (NO) and improves blood vessel dilation, or zinc and vitamin D, which help produce pituitary hormones, can help improve symptoms.
Professor Kim also emphasized the need for active treatment, especially for patients with obesity. This is because if you are obese, your blood concentration of the male hormone testosterone is likely to be low. Obesity affects hormone regulation functions, so even if the body secretes testosterone normally, the amount converted to estrogen, a female hormone, increases.
Professor Kim Young-sang of Family Medicine at Bundang CHA Hospital giving a presentation at the Korean Menopause Society’s fall conference on the 10th. Photo = Reporter Choi Ji-hyeon.
Testosterone treatment should be avoided in cases like this!
There are some patients who need to be careful about the side effects and treatment of testosterone treatment. Professor Kim pointed out, “When treating menopausal syndrome that does not aim to improve sexual function, it is better not to use hormone treatment,” adding, “If the effect of improving symptoms is insufficient even after 12 months of hormone treatment, it is necessary to discontinue it and take a functional medicine approach.” did.
In addition, patients with prostatitis, prostate cancer, cardiovascular disease, or sleep problems need to refrain from testosterone treatment. This is because there have been reports in the past that testosterone injections cause these diseases, so caution is needed. However, he added, “Recent studies are leaning toward the conclusion that the medical basis for these cases is thin.”
If you are a relatively young man, it is best to avoid hormone treatment. This is because there are clinical reports showing that long-term testosterone treatment reduces the size of the testes by about 5%. Although testicular size partially recovers after one month of discontinuation of treatment, Professor Kim recommended that young men refrain from undergoing treatment due to the possibility of pregnancy.
Professor Kim also added that patients do not need to be very concerned because physical and mood changes due to hormonal changes during the treatment process are common side effects. The side effects include acne, folliculitis, and gynecomastia.
Meanwhile, in the same session on this day, △Director Lee Sang-hoon (family medicine specialist) of GC Green Cross iMed Gangnam Center Functional Medicine Clinic and △Professor Seo Eun-kyung of Gangnam Chaum Detox Slimming Center introduced chronic fatigue in menopausal patients.
These presenters said that the main causes of chronic fatigue in menopausal patients are △ decreased mitochondrial function (reduced metabolic function) due to decreased secretion of sex hormones (estrogen or testosterone) △ decreased secretion of adrenal hormones such as cortisol (adrenal fatigue) and autonomic nervous system imbalance. The effects of △ liver detoxification metabolism due to changes in the intestinal microorganisms (microbiome) and brain effects of decreased nerve function were cited.
A commemorative photo (above) of the fall conference of the Korean Menopause Society held on the 10th and Chairman Oh Han-jin of the Korean Menopause Society (Department of Family Medicine, Eulji University Hospital) giving an opening speech. [사진=대한갱년기학회]
2023-12-14 15:00:35
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