More and more men, over the age of 50, are experiencing a series of difficult-to-explain symptoms: persistent fatigue, decreased sex drive, erection problems, increased abdominal fat, loss of muscle mass, low mood, and even difficulty concentrating or remembering simple things. Many attribute this to natural aging or stress, but behind these symptoms may be a syndrome that, although little known, is more common than we think: MOSH syndrome.
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What is MOSH syndrome?
Just as we can say that obesity is the epidemic of the 21st century, we could talk about another epidemic linked to it. One that is less known because social taboos prevent it from being talked about openly. We are talking about the case of obesity. MOSH syndrome. Or what is the same: hypogonadism male.
We can affirm that the hypogonadism and obesity are linked because obesity causes insulin resistance and increased production of estrogen. In the Baltimore study, published by Mulligan 10 years ago, it was revealed that around 39% of the male population aged 45 or older suffered from hypogonadism, and only 5% are treated.
MOSH It is an acronym for the English word (male obesity associated with secondary hypogonadism).
The concept of MOSH It is useful, because attributes to obesity its real importance as the origin of problems in men on the table:
- decrease in physical strength
- energy
- loss of emotional control
- lack of libido
- decreased sexual potency
How is this syndrome treated?
Hypothetically, what could we do with a male who presents the following symptoms?
- decay
- lack of libido
- erectile dysfunction
- loss of muscle mass
- osteoporosis
- increase in visceral fat mass
- lack of vital energy
- memory loss difficulty concentrating
- disorientation
- Insulin Resistance
First of all, it would be necessary perform an analytical profile to check blood parameters and, if any of these conditions are met:
- that total testosterone is < 230 ng/dl
- that free testosterone is < 8 ng/dl
We would prescribe a testosterone replacement therapy and once completed, new tests would be carried out to see if the situation has reversed and normalised. Depending on each patient, it may be necessary to repeat the treatment. It is important to take into account whether fertility is to be preserved, in which case the medication of the prescribed treatment may change.
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Treatment for MOSH syndrome
With the increase in safety in the treatment of hypogonadism male, research shows that it helps these patients lose weight and improve their metabolic profile. According to recent research, testosterone replacement therapy (TRT) is associated with:
- weight loss
- decreased waist circumference
- better glycemic control
Thus, according to the criteria set out by Aftab, Kumar, and Barber (2013), the diagnosis of MOSH can be made when the following factors are present:
- Men with BMI greater than or equal to 30 kg/m2
- The presence of symptoms of possible hypogonadism such as: worsening sexual, physical or mental performance, loss of masculine physical attributes, sleep problems, changes in blood glucose, hot flashes, low bone mineral density, increase in visceral fat…
- Laboratory tests that indicate changes (total testosterone or free testosterone)
- Normal or low FSH and LH levels without a setting of advanced hypopituitarism
Conclusions of the Medical Director of Doctor T Clinics
There is a close relationship between obesity (and the whole sedentary lifestyle that most of us lead) and a pathological reduction in testosterone levels. The MOSH concept will be useful to boost the diagnosis of these hormonal changes in men who are at risk, and yet were not investigated; that replacement therapy may come to help obese patients with hypogonadism to improve their metabolism, quality of life. Despite being a very promising topic, I want to make it clear that there is no magic and there is no universal declaration of improvement without personal effort.
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