Syndrome Differentiation and Treatment of Male Menopause
In recent years, with deeper research into male disorders, the concept of male menopause has emerged. Male menopause refers to a syndrome occurring in males aged 45–60 due to degenerative changes in the gonads, disrupting the balance of the hypothalamus-pituitary-gonadal axis. It manifests primarily as subjective mental sensitivity, decreased capacity, reduced libido or decline, fatigue, lethargy, memory loss, attention deficits, sleep disturbances, irritability, dizziness, sweating, osteoporosis, etc.
Male menopause falls under the category of “male zang-zao” in traditional Chinese medicine. It arises from depletion of kidney essence, declining kidney qi, gradual exhaustion of heavenly癸 (Tian Gui), blood and qi shifting from abundance to decline, physical strength weakening, fertility diminishing. Or due to congenital insufficiency, constitutional weakness; improper diet, irregular living habits; emotional distress (worry, anger, sorrow); excessive indulgence in sexual activity, leading to excessive depletion of essence and blood. These factors affect the generation of essence and blood, filling of marrow sea, regulation of qi movement, and expression of emotions, ultimately resulting in kidney deficiency and imbalance of yin and yang, triggering male menopausal syndrome.
TCM syndrome differentiation generally includes the following three types:
1. Liver-Kidney Yin Deficiency with Internal Fire Rising
Main symptoms: Slim build, palpitations, restlessness, insomnia with vivid dreams, dizziness, blurred vision, tinnitus, soreness and weakness in waist and knees, five palms feeling hot, hot flushes, night sweats, dry throat and mouth, nocturnal emission, irritability, reduced libido, red tongue with little coating, stringy and weak pulse. Treatment: Nourish liver and kidney, clear deficient fire. Mainly use Zhi Bai Di Huang Wan or Qi Ju Di Huang Wan with modifications.
2. Liver Qi Stagnation with Spleen Deficiency and Imbalance of Essence and Blood
Main symptoms: Irritable, sighing easily, chest tightness and rib pain, epigastric distension, poor appetite, loose stools or diarrhea, soreness and weakness in waist and knees, nocturnal emission, reduced libido, nausea, vomiting, fatigue, palpitations, sweating; stringy and slippery pulse, white or thick greasy coating. Treatment: Soothe liver, strengthen spleen, nourish blood, replenish essence. Use Chai Hu Shu Gan San combined with Liu Wei Di Huang Wan with modifications.
3. Kidney Essence Deficiency with Dual Yin-Yang Deficiency
Main symptoms: Relatively obese, cold limbs, facial or lower limb edema, pale complexion, introverted personality, silence, low spirits, soreness and weakness in waist and knees, unable to endure labor, low libido, erectile dysfunction, frequent urination, alternating diarrhea and constipation. Dry earlobes, loose teeth, hair loss, pale dark tongue, dry white coating, deep fine weak pulse. Treatment: Warm yang, tonify kidney, supplement both yin and yang. Use Jin Kui Shen Qi Wan combined with Shui Lu Er Xian Dan with modifications.