l Written by Dr. Lee Seung Hwan, Chief Director at Tong-in Korean Medicine Clinic
"A few years ago, one acupuncture session was all it took whenever my back hurt — why is it taking so long this time?"
A patient in their 40s who had been coming to Korean Medicine Clinic for eight years tilted her head, puzzled. She'd visited for a similar complaint, seen the same practitioner, and received the same treatment. So why was the recovery so much slower?
I pause, then answer gently.
"Even the finest car loses performance and breaks down more often as it gets older. Our bodies are no different — which is exactly why they need more attention and care as the years go on. It's a hard truth."
Today, I'd like to walk you through three reasons why energy drops after 40 from a Korean medicine perspective — along with the solutions we actually use in practice.
Hormonal Decline and Slowing Recovery
The Huangdi Neijing(황제내경) — one of the oldest texts in Korean and East Asian medicine — describes aging through cycles of seven for women and eight for men. Here's what it says about the 40s:
- Women: At 42, the face begins to look drawn and hair starts to turn grey. At 49, menopause arrives and fertility declines.
- Men: At 40, hair loss begins and the teeth weaken. At 48, the face grows drawn and the hair around the ears turns white.
Korean medicine attributes these changes to a decline in Shin-gi (신기) — the body's foundational energy, which governs growth, reproduction, and aging. In modern terms, this corresponds to a decrease in hormone production and a decline in cellular function.
Menopausal Symptoms in Your 40s — For Both Women and Men
While timing varies from person to person, hormone levels in both women and men gradually decline from the 40s onward, bringing with them a range of menopausal symptoms.
Women may experience irregular periods, changes in menstrual flow, hot flashes, facial flushing, mood swings (depression, irritability), fatigue, digestive issues, insomnia, and recurrent urinary tract infections. The hormonal upheaval can affect body and mind as profoundly as puberty.
Men, too, may face a decline in libido, erectile dysfunction, loss of motivation, anxiety, depression, and chronic fatigue — changes that can strain intimate relationships and create emotional distance between partners.
In Korean medicine, these symptoms point to what's called kidney yin or yang deficiency — a depletion of the body's foundational energy. Treatment typically involves herbal formulas to replenish the body's vital reserves — along with Jahageo pharmacopuncture.
Jahageo — A Medicinal Preparation Derived from Human Placenta
For these conditions, Korean medicine draws on herbal formulas and Jahageo pharmacopuncture.
- Jahageo (자하거) is derived from dried and processed human placenta. It is rich in cell growth factors, coagulation factors, hormones, and their precursors — and works to replenish qi (vital energy), blood, and the body's foundational reserves.
Jahageo preparations have also been used in clinical settings to support overall health in older adults, ease menopausal symptoms, manage chronic liver conditions, and prevent herpes virus recurrence. Research has also shown benefits for ligament and tendon regeneration when applied to musculoskeletal injuries.
In Korean medicine, applications extend beyond musculoskeletal care to include endocrine disorders, immune-related conditions, and gynecological health — with particular effectiveness for menopausal hot flashes and facial flushing.
Muscle Loss and Declining Metabolism
From your 40s, muscle quietly starts to disappear. Less muscle means a slower metabolism — and suddenly, the same meals start showing up differently on the scale.
People in their 40s and beyond almost always ask the same questions:
"What should I eat to get my energy back?"
"Which is better — Gyeongokgo or Gongjindan?"
"Can you recommend some supplements?"
My answer is always the same: "Before you keep adding things to your routine, start by cutting out the things that aren't helping."
The Basic First — Eat Less, Move More
We all know this. If you're in your 40s and carrying extra weight, the place to start is diet and exercise. Less food, more movement. There is no secret formula.
Alongside weight loss, alcohol and cigarettes need to go as well. If that nightly drink is the hardest habit to break, non-alcoholic beer is a decent stand-in — no judgement.
Beyond that, here's how Korean medicine can help:
✔️ A thorough assessment — body composition, constitution, and abdominal check
✔️ Custom herbal formulas tailored to your body type
✔️ Targeted pharmacopuncture or electroacupuncture where needed
✔️ Ongoing guidance on diet and lifestyle — grounded in your constitution
For a deeper look at Korean medicine's approach to weight management, please refer to our earlier journal.
→ Read the ‘Korean Medicine Diet’ Journal
Chronic Stress and Elevated Inflammation
The weight on your shoulders in your 40s is real. You're past the studying-only days of your 20s and the trial-and-error days of your 30s — now more is expected of you, by everyone, including yourself.
The list never seems to end: aging parents, growing children, mortgages, investments, retirement planning. And somehow, you're expected to keep pace with a world that won't slow down for anyone.
The data reflects this. In 2024, adults in their 40s reported the highest stress awareness rate of any age group in Korea — 35.1%, up sharply from 26.9% in 2014.
Warming the Body — Through Bathing and Moxibustion
Most stress relief takes time to build. So I keep it simple — a warm bath.
Balneotherapy — soaking in warm water — benefits both body and mind: circulation, chronic pain, stress, sleep, and mood.
One study found that 15 minutes in mineral spring water (34.6°C), five times a week over two weeks, significantly reduced both stress and fatigue. Another showed that just 10 minutes a day in 40°C water produced similar results — better mood, better quality of life. Importantly, you don't need a mineral spring to see benefits — regular warm water can make a real difference too.
Not a bath person? Moxibustion at a Korean medicine clinic is a strong alternative — it raises the body's core temperature and supports immune function.
One last thing. Feeling drained in your 40s isn't always about your age. Sometimes it's the summer heat, or watching your country crash out of the World Cup, or your investments not going as planned.
Don't blame your age for everything. With good habits and steady effort, you can feel stronger, lighter, and more like yourself. That much I'm certain of.
> Book a Consultation through TPS — Tong-in Korean Medicine Clinic, Seoul
[Q&A]
Q. Why does energy drop so suddenly after 40?
Three factors tend to work together. First, declining hormones lead to energy deficiency. Second, muscle mass decreases, pulling down the resting metabolic rate. Third, chronic stress elevates inflammation throughout the body. Because all three happen simultaneously, the shift can feel sudden — as though the body changed overnight. Addressing each root cause is what makes the difference.
Q. What is Jahageo and what does it do?
Jahageo (자하거) is a preparation derived from dried and processed human placenta. It contains cell growth factors and hormone precursors. It is particularly effective for relieving hot flashes and facial flushing associated with menopause.
Q. How is Korean medicine's approach to weight loss different?
Korean medicine focuses on body balance — not just the weight itself. A sluggish metabolism and stress-driven overeating call for different tools: metabolic herbal formulas for the former, appetite-regulating formulas for the latter. Where needed, pharmacopuncture or electroacupuncture may also be used.
| Edited by Sia Shin, The Pylon Square
