内容監修
NORIAKI L. SANTO
NORIAKI L. SANTO
Doctor / CLINIC TEN SHIBUYA Director
Dr. Santo graduated from the School of Medicine, University of Tsukuba, where he received the President’s Award and participated in a government-sponsored study program in the United States. He began his career in the Department of Urology at the National Hospital Organization Tokyo Medical Center, later serving as Assistant Professor in the Department of Urologic Oncology at Saitama Medical University International Medical Center, and completing the Harvard University ICRT Program Japan. Qualifications: – Licensed Physician – da Vinci Console Surgeon – Harvard University Alumnus – Massachusetts Institute of Technology
Introduction
CLINIC TEN SHIBUYA is a medical clinic located in Shibuya Ward, Tokyo. We provide a a safe and reassuring environment for foreign patients living in Japan to receive testosterone replacement therapy.
Consultations are provided in English by our physician.
However, please note that our reception and nursing staff may not be fluent in English.
Membership registration and reservation pages are in Japanese. We apologize for any inconvenience and appreciate your understanding.
Testosterone, which declines with age, can be replenished through treatment.
Testosterone, also known as the male hormone, peaks in the twenties and decreases as one ages. Low testosterone levels are known not only to cause erectile dysfunction (ED) and other declines in sexual function but also to reduce motivation and vitality, and to contribute to depression. In addition, low testosterone makes body fat more likely to accumulate and increases the risk of heart problems such as myocardial infarction, with wide-ranging effects throughout the body.
This decline in testosterone can be improved by supplementing the hormone through treatment. Although many supplements claiming similar effects are widely sold, the only scientifically proven method to restore testosterone levels is testosterone replacement therapy (TRT).
At CLINIC TEN SHIBUYA, we provide a safe and reassuring environment for patients to receive testosterone replacement therapy.
Treatment in Partnership with a Trusted Physician
Our TRT begins with a physician capable of speaking English and carefully listening to each patient’s concerns and symptoms. We then explain the recommended treatment and its risks in detail, followed by necessary blood tests to confirm that treatment can safely begin (treatment is basically not started at the first visit).
We never push unnecessary treatments, and in some cases, the decision may be that no treatment is required. Furthermore, we not only provide testosterone supplementation but also conduct medium- to long-term follow-up on both physical and mental health, as well as blood test results.
We do not leave treatment to patients’ responsibility alone but provide medical care with full commitment.
Testosterone replacement therapy may involve side effects. However, by being mindful of risks and monitoring physical changes, it is possible to minimize them. This is why walking this path together with a trusted physician is so important.
A Private and Comfortable Setting
Some may feel hesitant about visiting a men’s health clinic, perhaps finding the waiting room atmosphere uncomfortable.
At CLINIC TEN, we operate on an appointment-only-basis. Patients are guided directly to the consultation room upon arrival, without using the waiting room. As we also provide general internal medicine and health checkups, our clinic is designed to be as approachable as any other clinic.
The environment has been designed to promote calm communication between physician and patient.
Why not begin by re-evaluating your vitality with a simple test and consultation? CLINIC TEN SHIBUYA is here to support you.
Men Also Experience “Andropause”
While the forties are often considered the prime of working life, many men experience both mental and physical difficulties. In particular, many report frustration at not being able to perform as they once did.
Some resign themselves, saying:
– “It’s just age; nothing can be done.”
– “It’s natural that I can’t be like my younger self.”
However, behind such symptoms may lie a decline in testosterone.
Possible Symptoms and Changes from Low Testosterone
– Reduced motivation and vitality
– Sleep disturbances
– Accumulation of body fat
– Decline in sexual function, ED, reduced libido
– Cardiovascular problems
– Decreased bone density
Physical problems such as obesity noted in health checkups, or greater susceptibility to illness, as well as psychological issues like depression or lack of motivation, may begin as early as the late thirties.
In fact, testosterone begins to decline after peaking in the twenties. Despite needing supplementation, many men—known as the “non-intervention group”—continue to live with low testosterone levels untreated.
Symptoms caused by testosterone decline are often overlooked, as they do not involve acute pain or bleeding. Yet, with appropriate treatment, such symptoms can be improved, leading to better quality of life (QOL).
Our clinic offers testosterone testing and replacement therapy to help men with these concerns lead easier, healthier lives.
The Importance of Regular Testing
Even if you currently have no symptoms, regularly measuring testosterone has value. For example, it can help predict the onset of symptoms due to low testosterone, and when symptoms do appear, it helps clarify their cause.
A 2020 U.S. study reported that testosterone levels in the blood of younger men (teens to thirties) have declined compared to about 20 years ago. This suggests that more men with low testosterone may emerge in the future.
As part of preventive health care, we recommend regular hormone testing and health consultations with a physician beginning in the mid-thirties. At our clinic, if results indicate no treatment is necessary or if the patient does not wish to proceed, we never pressure anyone with excessive promotion or fear-based messaging.
Expected Benefits of Testosterone Replacement Therapy
When testosterone levels are restored to normal through treatment, patients can regain a state closer to their youthful condition before hormone decline.
In addition to improved mood and motivation, physical problems such as ED may also be alleviated. TRT may also increase muscle mass.
At present, evidence is insufficient to conclude that TRT improves cardiovascular health or bone density, and further research is needed. At CLINIC TEN, we only present as benefits what is scientifically well-established.
Patients Who Cannot Receive Treatment
Due to potential risks, some patients cannot undergo TRT.
It is said that TRT may worsen advanced prostate enlargement or prostate cancer. Therefore, prior testing is required to rule out such conditions. If suspected, treatment cannot be provided. However, TRT does not increase the risk of developing prostate cancer in men who did not already have it.
There are also some reports suggesting TRT may worsen sleep apnea, but most studies indicate the link is weak.
At our clinic, only prostate cancer screening is performed beforehand. If suspected, we refer patients to a specialist rather than proceed with TRT.
Possible Side Effects of Treatment
As testosterone affects many parts of the body, TRT may cause side effects. Like all medical treatments, even something as simple as one pill carries risks. It is important to understand both benefits and risks, and to work together with a physician toward safe improvement.
Reported side effects include:
– Liver dysfunction
– Polycythemia (thickened blood)
– Reduced HDL cholesterol (with high doses)
– Acne, increased body hair
– Breast enlargement or decreased libido (if testosterone rises above normal range)
– Testicular dysfunction and male infertility
These risks are generally low as long as testosterone remains within the proper range. Therefore, regular checkups and blood tests are essential.
Message from Our Physicians
For most men, testosterone begins to decline in their thirties. With proper therapy, not only can lost vitality be restored, but patients may even update themselves into a better version than before.
Furthermore, some reports suggest TRT lowers the risk of lifestyle-related diseases and cardiovascular events, making it a meaningful investment for the future.
Simply knowing your current condition and monitoring regularly has great value. Do not dismiss changes in your health as “just aging.” We encourage you to come in for a consultation.
Would you like to explore together a better way of living as a man?
Book your Men’s Health Consultation at CLINIC TEN.
Details of Treatment
Initial Consultation and Blood Test (Testosterone Check)
Alongside your consultation with a physician, we perform blood tests to measure total testosterone and free testosterone (biologically active form). Other hormones possibly related to male menopause symptoms are also measured. Additional tests are conducted as preparation for potential treatment.
If testosterone (especially free testosterone) is found to be low, or if other test results support it, treatment with medication will be recommended.
Testosterone Replacement Therapy (TRT)
TRT is the replenishment of testosterone using medication. Injection is most common, but topical formulations are also available.
For younger patients or those wishing to have children in the future, indirect methods may be considered, such as hCG (human chorionic gonadotropin) or clomiphene (Clomid), which stimulate natural testosterone production.
For ED, PDE-5 inhibitors may be prescribed.
Herbal medicine may also support treatment, such as Hochuekkito, Keishikaryukotsuboreito, Saikokaryukotsuboreito, Hachimijiogan, or Gosha-jinki-gan.
Treatment plans are decided in consultation with your physician, taking into account symptoms, preferences, and life plans.
Costs
Our TRT is primarily self-funded, though some treatments may be covered by insurance depending on the condition
(All prices include tax.)
First Visit
| Initial Consultation（30 minutes) | ¥5,500 |
| Initial Blood Test | ¥16,500 |
Treatment
| Follow-up Consultation | ¥2,750 |
Injections
| Testinon Depot 125 mg | |
| Testinon Depot 250 mg | ¥ |
| REANDRON®（NEBIDO®） 1000mg | |
| Sustanon 250mg | ¥ |
Topical Medication
| 1UP Formula (5% Testosterone topical) | ¥2,750 (prescription fee) + ¥12,100 (to pharmacy) |
Oral Medication for Side Effect Prevention (e.g., testicular function maintenance)
| Clomid 50 mg | ¥6,600 (30 tablets) |
| Anastrozole 1 mg | ¥5,500 (30 tablets) |
Blood Tests
| Side Effect Monitoring | ¥2,200 |
| Hormone Level Check | ¥5,500 |
reservation calendar
References and Further Reading
- Testosterone Deficiency in Young Men: Marked Alterations in Whole Body Protein Kinetics, Strength, and Adiposity1
- Iwamoto A, et al. *Age-related distribution of free testosterone in Japanese men.* Jpn J Urol 95: 751, 2004
- Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA
- Total testosterone is the most valuable indicator of metabolic syndrome among various testosterone values in middle-aged Japanes
- Endogenous Testosterone and Mortality Due to All Causes, Cardiovascular Disease, and Cancer in Men
- Testosterone dose-response relationships in healthy young men
- Effects of Testosterone Therapy in Adult Men: A Systematic Review and Meta-Analysis
- Testosterone replacement therapy (TRT) and prostate cancer: An updated systematic review with a focus on previous or active localized prostate cancer
- Testosterone therapy and obstructive sleep apnea: is there a real connection?
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