Attention Climacteric Women and Middle-Aged Men: Could You Have Sarcopenia? When Your Physical Stamina Hits Rock Bottom

“Doctor, lately it is hard to climb stairs, and my wrist strength seems weaker.” Many people share this concern these days. Modern medicine terms this sarcopenia, defining it as a condition where not only muscle mass decreases, but muscle weakness and physical hypofunction also develop. The World Health Organization (WHO) has assigned it a disease code, and it is now recognized as a distinct disease. While sarcopenia is known to occur mainly in the elderly, recently it is also frequently observed in climacteric women and middle-aged men dealing with frequent stress and irregular lifestyles. In climacteric women especially, the rapid drop in the female hormone estrogen hinders muscle protein synthesis, leading to a tendency toward rapid loss of muscle mass and strength. Men also begin to lose muscle mass as levels of the androgen testosterone gradually decline from their late 30s. Why, then, does muscle disappear like this? Modern science points to several complex factors. First, the aforementioned **hormonal imbalance**. Secretion of hormones essential for muscle growth—not only estrogen and testosterone, but also growth hormone (GH) and insulin-like growth factor 1 (IGF-1)—decreases with aging. These hormones promote muscle protein synthesis and repair muscle damage; when they are deficient, the rate of proteolysis outpaces the rate of new muscle creation. Second, **chronic inflammation and oxidative stress**. When inflammatory responses persist or reactive oxygen species are excessively produced in the body, muscle cells are damaged and muscle proteolysis is accelerated. This resembles the hypofunction of muscle cells acting like a rusted machine. Third, **hypofunction of the neuromuscular junction**. For muscles to move, nerve signals sent from the brain must be precisely transmitted to the muscles, but aging introduces problems into this signal transduction pathway. As the number of motor nerves innervating muscles decreases or their function declines, muscle contractility weakens, which can lead to muscular atrophy. Fourth, **insufficient and imbalanced protein intake**. Muscles are made of protein, but as one ages, protein intake often becomes insufficient, or the body fails to utilize ingested protein properly. In particular, without sufficient intake of essential amino acids such as leucine, which stimulates muscle protein synthesis after meals, an unfavorable environment for muscle generation is created. Fifth, **decreased activity and an unbalanced lifestyle**. Modern sedentary habits and physical inactivity reduce opportunities to use muscles, naturally accelerating muscle loss. Furthermore, chronic diseases such as diabetes, cardiovascular disease, and chronic kidney disease can further increase sarcopenia risk. Such sarcopenia does not end merely with feeling physically weak. It significantly impairs quality of life by increasing fall risk due to reduced balance, worsening diabetes due to increased insulin resistance, causing decreased immunity, and even triggering depression. Just as Donguibogam stated that the spleen and stomach are the root of muscle, modern medicine also sees that muscle health is not simply a matter of exercise, but closely connected to whole-body health. One realizes anew that Eastern and Western medical wisdom converge in recognizing that digestive function responsible for nutrient absorption, energy metabolism, hormonal balance, and cellular-level health must all work in harmony to maintain healthy muscles.