Andropause (Male Menopause) Treatment in Tokyo
Andropause — also known as male menopause or medically as Late-Onset Hypogonadism (LOH) syndrome — is a gradual decline in testosterone that affects men typically from their 40s onward. Unlike female menopause, which occurs relatively suddenly, andropause develops slowly over years, making it easy to dismiss as simply “aging.” Yet the impact on quality of life can be profound: persistent fatigue, mood deterioration, reduced sexual function, and loss of motivation are not inevitable parts of growing older — they are often treatable.
Last updated: March 2026. Content supervised by medical professionals at Tokyo Hub Clinic.
At Tokyo Hub Clinic, Dr. Ichiro Kamoshita, M.D., Ph.D., is one of Tokyo’s few English-speaking physicians with specialized expertise in andropause diagnosis and treatment. If you are an expat or international resident experiencing these changes, you can discuss your concerns entirely in English at our clinic inside Hotel New Otani Garden Court, 2F (Chiyoda-ku, Kioicho 4-1).
Recognizing the Symptoms of Andropause
Andropause does not arrive with a single dramatic event. Instead, symptoms accumulate gradually, and many men do not connect them to a hormonal cause. Common symptoms include:
- Persistent, unexplained fatigue — feeling drained despite adequate sleep
- Depressed mood or emotional flatness — loss of joy, motivation, or sense of purpose
- Irritability and mood swings — short temper over minor issues
- Decreased libido — noticeably reduced interest in sex
- Erectile dysfunction — difficulty achieving or maintaining erections
- Cognitive changes — poor concentration, forgetfulness, mental fog
- Sleep disturbances — insomnia, restless nights, or early waking
- Loss of muscle mass and strength — despite regular exercise
- Increased abdominal fat — especially around the midsection
- Night sweats or hot flashes — similar to female menopausal symptoms
- Joint stiffness and general aches
- Reduced confidence — feeling less capable or self-assured
Many of these symptoms overlap with depression, burnout, or thyroid disorders — which is why proper medical evaluation is essential rather than self-diagnosis.
How We Diagnose and Treat Andropause
Dr. Kamoshita brings a unique advantage to andropause care: his dual expertise in psychosomatic medicine and men’s hormonal health. This combination is critical because andropause symptoms frequently intertwine with psychological factors. A doctor who only looks at hormone numbers may miss the full picture, while a therapist who does not check hormones may treat the wrong cause.
Our diagnostic approach includes:
- Comprehensive symptom assessment using validated questionnaires (such as the AMS — Aging Males’ Symptoms scale)
- Detailed medical and lifestyle history — medications, sleep patterns, stress levels, alcohol use
- Blood hormone panel — total testosterone, free testosterone, SHBG (sex hormone-binding globulin), LH, FSH, and prolactin
- Screening for other causes — thyroid function, cortisol, vitamin D, complete blood count, metabolic panel
- Psychological evaluation — assessing whether depression, anxiety, or chronic stress may be contributing
Understanding Your Results
In Japan, LOH syndrome is generally diagnosed when free testosterone falls below 8.5 pg/mL in the presence of clinical symptoms. However, some men experience significant symptoms even with testosterone levels in the “low-normal” range. Dr. Kamoshita considers the complete clinical picture — not just numbers — when developing your treatment plan.
How Andropause Differs from Female Menopause
While female menopause involves a relatively rapid cessation of reproductive hormones over 2–5 years, andropause is a slow, continuous decline. Testosterone typically decreases by approximately 1–2% per year after age 30. This gradual nature means many men adapt to their declining function without realizing how much they have lost. Additionally, not all men will develop clinically significant andropause — genetic, lifestyle, and health factors all play a role.
Awareness in Japan
Andropause remains significantly under-recognized in Japan compared to Western countries. Many Japanese physicians outside of specialized urology clinics may not routinely test for it, and public awareness is low. For English-speaking residents, this gap is compounded by the language barrier — making it even harder to find appropriate care. Tokyo Hub Clinic bridges this gap by providing expert-level andropause evaluation in English.
What to Expect at Your Visit
Step 1: Appointment Booking
Call 03-6261-7070 or use our online booking. We operate on a reservation-only basis. When booking, let us know you are interested in an andropause or hormone evaluation.
Step 2: Initial Evaluation
Your first visit includes a detailed interview with Dr. Kamoshita (entirely in English), physical assessment, and blood draw for hormone testing. Plan for approximately 30–45 minutes. Morning appointments are preferred, as testosterone levels are highest in the early morning.
Step 3: Results Review and Diagnosis
Once blood results are available (typically 3–5 business days), you will return for a follow-up where Dr. Kamoshita explains your results clearly, discusses the diagnosis, and outlines treatment options. There is no rush — your questions are welcome.
Step 4: Treatment Plan
Based on the severity of your condition and personal preferences, a treatment plan is created. This may involve hormone therapy, lifestyle modifications, psychological support, or a combination.
Step 5: Follow-Up and Adjustment
Regular follow-up appointments allow us to track your progress, adjust treatment, and re-test hormone levels to ensure optimal outcomes. Most men begin to notice improvements within the first few weeks to months.
Treatment Options for Andropause
Treatment is tailored to each patient’s needs and may include:
- Testosterone Replacement Therapy (TRT): For men with confirmed low testosterone, injection-based TRT (testosterone enanthate) is the primary treatment in Japan. This is administered at the clinic every 2–4 weeks and is covered by NHI when medically indicated. Learn more about TRT.
- Lifestyle Optimization: Exercise (especially resistance training), improved sleep hygiene, stress reduction, and dietary changes can significantly support testosterone levels. Dr. Kamoshita provides specific, actionable guidance.
- Stress and Mood Management: Since andropause and psychological conditions frequently coexist, addressing stress, anxiety, or depression is often a key component of treatment. Dr. Kamoshita’s psychosomatic medicine background is particularly valuable here.
- Nutritional Guidance: Certain nutrients — zinc, vitamin D, magnesium — support testosterone production. We assess for deficiencies and recommend supplementation where appropriate.
- Medication for Specific Symptoms: If ED is a prominent symptom, PDE5 inhibitors may be prescribed alongside hormonal treatment. Sleep or mood medications may also be appropriate in some cases.
For Expats and International Residents
At Tokyo Hub Clinic, you benefit from:
- Full English consultation — no interpreters needed, no miscommunication
- A doctor who understands international patients’ needs — including different healthcare expectations and cultural contexts
- Discreet, comfortable setting — inside Hotel New Otani, accessible from Akasaka-mitsuke and Nagatacho stations
- Continuity of care — if you were being evaluated for andropause overseas, we can continue your assessment in Japan
You do not need to suffer through these symptoms alone or assume they are a normal part of aging. Help is available — in your language.
Insurance & Pricing
Andropause evaluation and treatment are covered by Japan’s National Health Insurance (NHI) when medically indicated. Typical costs with insurance:
- First visit (consultation + hormone blood panel): Approximately ¥10,000–¥15,000
- Follow-up visits: Approximately ¥5,000–¥8,000
- Testosterone injection (if prescribed): Covered by NHI at 30% copay
Self-pay options are available for patients without Japanese health insurance. We provide English-language medical documentation for overseas insurance claims. See our Pricing page for details.
Frequently Asked Questions
Is andropause a real medical condition?
Yes. Andropause, or Late-Onset Hypogonadism (LOH) syndrome, is a recognized medical condition with established diagnostic criteria. The underlying hormonal decline and its effects are well-documented in medical literature. The Japan Urological Association has published clinical guidelines for its diagnosis and treatment.
At what age does andropause start?
Testosterone begins declining gradually from around age 30, at a rate of approximately 1–2% per year. Clinically significant symptoms typically appear in the 40s or 50s, though some men may notice changes earlier or later depending on individual factors. There is no single “start date” — it is a gradual process.
How is andropause different from depression?
Andropause and depression share overlapping symptoms — low mood, fatigue, poor concentration, and loss of interest. The key difference is the underlying cause. Andropause is driven by hormonal decline, while depression has complex psychological and neurochemical origins. However, the two conditions frequently coexist and can worsen each other. Dr. Kamoshita evaluates both hormonal and psychological factors to provide accurate diagnosis.
Can lifestyle changes alone treat andropause?
For mild cases or borderline testosterone levels, lifestyle changes — regular exercise, improved sleep, stress reduction, and nutrition — can make a meaningful difference. However, for moderate to severe cases with significantly low testosterone levels, lifestyle changes alone are often insufficient, and TRT may be necessary. We assess each case individually.
Will I need treatment for the rest of my life?
It depends on the underlying cause and severity. Some men benefit from a defined course of treatment, while others require ongoing hormone replacement. Lifestyle factors can improve testosterone levels over time, potentially reducing the need for medication. Regular monitoring helps us determine the best long-term strategy for each patient.
Call 03-6261-7070 — Reservation required. Full English consultation available.
Related Pages
- Men’s Health Clinic in Tokyo
- Testosterone Replacement Therapy (TRT)
- ED Treatment in Tokyo
- Men’s Health Checkup & Hormone Testing
- About Dr. Kamoshita
- First Visit Guide