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Hypogonadism, sometimes called gonad deficiency, occurs when your sex glands (males usually have testes and females usually have ovaries) produce little if any sex hormones. Hypogonadism can be inherited or acquired. It may occur due to insufficient hormone production in the brain or primary disturbances in the ovaries or testes.
It affects teenagers and adults of all genders and is often the culprit of low sex drive (libido). Menopause is an inevitable event that causes plenty of physiological variation in people who have ovaries due to natural decreases in estrogen production.
Testosterone production also wanes over time in people who have testes. Natural treatments and lifestyle changes—like monitoring what you eat, using herbal supplements, and changing your exercise routine—have long been used to offset the symptoms of hypogonadism.
This article will explain the most common all-natural treatments for hypogonadism in men and women and why they may be important to traditional hypogonadism therapy.
Getting Older or Hypogonadism?
In general, sex drive decreases gradually with age in all sexes. Waning testosterone levels govern declines in sex drive in men and waning estrogen levels in women.
While the decline is often gradual and modest, physiological changes of aging also cause similar signs and symptoms to hypogonadism, so teasing out the changes in sex drive that are due to aging or hypogonadism can be difficult.
Some recent studies show that raising testosterone levels can benefit older men who have low testosterone. The drawbacks are that these studies are small or haven't observed the subjects over an extended time to reach definitive answers.
Age-related decreases in testosterone may also reduce desire in post-menopausal women, as this hormone plays a role in women's sex drive and sexual sensation. Still, the precise role of testosterone in desire is complex and not well understood.
Understanding Hypogonadism Symptoms
Hypogonadism is a deficiency in hormones estrogen and testosterone, chemical messengers that carry out a multitude of physiologic processes throughout the body.
Estrogen and testosterone, both of which are produced in all sexes, affect growth and development, metabolism, sexual function, reproduction, and even your mood. When these levels are off, multiple systems are out of wack, helping to explain the variety of symptoms you might experience.
When your estrogen levels are off, your body can feel off too. Estrogen, the main female hormone, affects the brain, cardiovascular system, musculoskeletal system, urinary tract, and even hair and skin, so there are numerous symptoms that you may experience if you have insufficient amounts.
Menopause causes a drop in estrogen. This impacts all the aforementioned processes. Estrogen deficiency can make itself known via hot flashes, changes in your energy and mood, and irregular menstruation.
Common symptoms of hypogonadism in people with ovaries include:
- Loss of menstrual periods (amenorrhea)
- Decreased energy and interest in activities
- Low mood
- Sleep disturbances
- Night sweats
- Osteoporosis (weakening of the bone structure)
- Lack of breast development
- Low sex drive
- Body hair loss
- Hot flashes
- Stunted growth
- Vaginal dryness
- Painful intercourse
- Aches and pains, including headaches, muscle, and body aches
Estrogen’s effects on the body are also dependent on the activity of its hormone “cousin,” progesterone, which prepares the lining of the uterus (womb) for a fertilized egg, supports pregnancy, and suppresses estrogen production after ovulation.
Low estrogen levels may impact progesterone, testosterone, and other hormone levels.
Testosterone plays a central role in so many physiological processes throughout the body. Not surprisingly, hypogonadism in adult men affects everything from energy and muscle mass to sexual function and sleep.
Common symptoms of hypogonadism in men include:
- Erectile dysfunction
- Low sperm count
- Depressed mood
- Decreased libido
- Extreme fatigue or lethargy
- Sleep disturbances
- Decreased muscle mass and strength
- Loss of body hair (pubic, axillary, facial)
- Osteoporosis and decreased bone mineral density
- Increased body fat
- Breast discomfort and enlargement
- Hot flashes
- Poor concentration and decreased energy
Menopause is the most common reason for hypogonadism in females. In males, natural decline in testosterone levels with age is the most common reason for hypogonadism. Still, not all people develop hypogonadism.
It’s unclear why some people develop hypogonadism and others do not, but there are some conditions that may affect your sex glands or the signal from your brain to your gonads that can impact the body’s ability to produce sufficient amounts of sex hormones. These conditions include:
- Cancer treatments, including radiation therapy and chemotherapy
- Eating disorders such as anorexia nervosa and bulimia
- Genetic disorders affecting the number of X and Y chromosomes, such as Turner syndrome or Klinefelter syndrome, or affecting brain development, such as Prader-Willi syndrome
- Hemochromatosis (a hereditary condition that leads to excess iron in the blood)
- Hormonal disorders such as diabetes or Addison’s disease
- Inflammatory diseases, such as sarcoidosis
- Liver disease or kidney disease
- Pituitary tumors (adenomas) and disorders
- Undescended testicles
Additional risk factors for hypogonadism include:
- Brain surgery and/or surgery on reproductive organs
- Drug use, specifically anabolic steroids or opioid use
- Infections, like HIV
- Weight loss, especially rapidly shedding weight
Conventional treatment is dependent on whether your hypogonadism is due to primary dysfunction of the ovaries and testes or central causes—that is a deficiency of luteinizing hormone and follicle-stimulating hormone production by the pituitary gland in the brain.
It is imperative to identify and treat the underlying cause of hypogonadism before moving on to conventional treatment methods like hormone replacement therapy (HRT). HRT has proven to be an effective first-line treatment for hypogonadism in men and premenopausal women.
In women, estrogen may be administered in the form of a patch or pill. In men and some women (as needed, especially for those with low sex drive), testosterone can be given by a patch, a product soaked in by the gums, a gel, or by injection.
Of note, if you have had your uterus removed, your healthcare professional may suggest using a combination of estrogen and progesterone to decrease the chance of developing endometrial cancer.
If the condition is caused by a pituitary tumor, treatment will include surgery to remove the tumor.
Initial treatment should address the causal factor of your hypogonadism wherever possible. If your hypogonadism continues to persist, hormone replacement therapy is usually initiated.
Most women, especially those with a uterus, will be placed on low-dose estrogen or combined estrogen and progesterone therapy given in the form of a low-dose contraception pill, patch, or injection to protect against cancerous changes that can happen along the lining, or endometrium, of the uterus.
Young females with a hysterectomy may be placed on high-dose estrogen to prevent osteoporotic fractures (weakened bones that result in a broken bone) and other hormonal changes.
Of note, not all women qualify for HRT. If you have had conditions such as breast cancer, high blood pressure, heart attack, stroke, or another type of blood clot, HRT is not recommended.
Initial treatment should address the causal factor of your hypogonadism wherever possible. If your hypogonadism is not resolved, hormone replacement therapy may be initiated.
Testosterone replacement therapy is the primary treatment option for hypogonadism. Ideally, the therapy should provide physiological testosterone levels, typically in the range of 300 to 800 nanograms per deciliter (ng/dL). Testosterone may be given in the following forms:
- Transdermal patch
- Topical gel
- Oral tablet
- Implantable pellet
- Buccal tablets (dissolvable pills placed in the side of mouth)
Natural therapies to increase testosterone and estrogen production include diet and exercise, weight loss, improved sleep, decreasing stress, eating hormone-stimulating foods, and taking well-studied supplements.
The greatest advantage to trying lifestyle changes such as diet, exercise, and weight loss is that it provides a means to potentially reverse other conditions that are closely linked to hypogonadism.
The go-to ways to increase estrogen and testosterone in the body are through diet changes and supplementation and exercise.
Vitamin E is a fat-soluble vitamin that plays an important role in the detoxification of estrogen. More vitamin E means more free estrogen in the blood.
Eating foods with phytoestrogen (plant-based compounds that have similar effects to estrogen) or foods that increase testosterone production can also be helpful. Foods that contain phytoestrogen include:
- Soybeans and soy products: Including miso, soy milk, tempeh, tofu
- Other beans: Kidney beans, lentils, navy beans, pinto beans
- Fruits: Dried prunes, peaches, raspberries, strawberries
- Grains: Barley, oats, rye, wheat
- Nuts: Almonds, pistachios
- Seeds: flaxseed, sesame seeds, sunflower seeds
- Vegetables: Broccoli, cabbage, collard greens, green beans, winter squash
Of note, if you have celiac disease (an autoimmune disease in which gluten causes your body to attack your intestinal lining) and low estrogen levels, you should avoid gluten. In celiac disease, gluten causes the release of stress hormones, which interfere with estrogen production.
Foods that boost testosterone levels include:
- Dairy milk and plant milk fortified with vitamin D
- Leafy green vegetables
- Fatty fish and fish oil
- Extra-virgin olive oil
Studies have also shown that three to five days of cardio and weight training exercise can also help females increase their estrogen levels. This is especially important after menopause in people who are at higher risk of osteoporotic fractures as they age.
Even more, getting regular sleep, losing weight, reducing stress, limiting alcohol, and stopping smoking have been found to not only regulate hormone levels but provide immense cardiovascular benefits, offsetting some of the medical conditions that contribute to hypogonadism.
Mental Well-Being and Emotions
Hypogonadism comes with a host of emotions, feelings, and symptoms that you have to unpack. Erectile dysfunction may cause you to feel less whole and contribute to sexual performance anxiety.
Sex therapy may be helpful when psychological issues like stress or anxiety are playing a role. You may attend with your partner or choose to go alone, although couples therapy has the added benefit of helping your partner learn ways to support you.
Talking to a therapist helps you understand and accept that emotions, such as anxiety or sadness, play an integral role in sexual dysfunction and may even become associated with or compounded by physical factors or reactions. This basis of sex therapy is that:
- Both partners share responsibility for helping solve the problem, even if it is due to physical causes.
- You and your partner receive information and education about sexual techniques.
- It is necessary to change any negative attitudes toward sex.
- It is necessary to open up lines of communication between you and your partner.
Cognitive behavioral therapy or counseling is helpful for those with general anxiety, depression, or post-traumatic stress disorder (PTSD) in people of any sex with hypogonadism. Oftentimes addressing mental health conditions improves libido and sexual performance.
While therapy or counseling is helpful, there are other stress-reducing therapies like acupuncture (placing thin needles in specific points to direct energy in the body) and exercise that can help. You may try "mindful movement" therapies like tai chi, qi gong, or yoga.
Like alcohol, stress interferes with erectile function and (in all sexes) libido or desire to have sex. All stress, good or bad, can affect sexual function. Common stressors include:
- Psychological stress (i.e., depression, PTSD, low self-esteem issues, sexual trauma)
- Performance anxiety
- Professional stress
- Life-altering events such as the death of a family member or friend, divorce, change in health, being hired or fired from a job, financial troubles, parenting or relationship problems
Practicing self-care, exercising, and talking to your partner can take the pressure off of you and even reverse your symptoms of hypogonadism to some degree.
There are some lifestyle changes you can make that can help you manage your hormone levels. Let’s start with the ways you can boost your estrogen levels naturally, these include:
- Eating phytoestrogen-rich foods (soy, other beans, nuts, seeds, fruits, and vegetables).
- Stopping smoking or other tobacco use
- Taking vitamin E and vitamin D
- Using ginseng
- Trying acupuncture. Some studies have found that acupuncture may increase estrogen, especially estradiol, as well as progesterone, prolactin, and other hormones.
Acupuncture to Boost Estrogen
Some studies have found that acupuncture may increase estrogen, especially estradiol, as well as progesterone, prolactin, and other hormones.
Some all-natural ways to boost testosterone include:
- Getting better sleep
- Eating a healthy diet, especially one that contains lots of fruits, vegetables, and fiber
- Reducing stress
- Adding more zinc to your diet
- Avoiding testosterone lowering chemicals like phthalates in plastic containers and some cosmetic products, like moisturizers
It is not uncommon for people with hypogonadism to feel pressure to perform or feel like they are not “feminine” or “manly” enough. Talking to your partner can be understandably difficult, but communication is a part of any healthy relationship and sex life.
Talking about your difficulties takes the pressure off you and informs your partner of what’s going on. It can also serve as an opportunity to engage in more pro-healthy behaviors like quitting smoking, exercising more, and eating a heart-healthy diet.
Joining a support group and reimagining your sex life are also worthwhile coping mechanisms. Not only can talking to strangers be a stress-reliever but hearing the thoughts and feelings of others can serve as a reminder that intimacy is more than sexual desire, penile penetration, or your mood at any given moment.
Hypogonadism is a condition in which a person doesn't produce enough sex hormones. It can develop due to a variety of underlying conditions, both those primarily affecting the testes or ovaries and those that affect them secondarily.
Hormone replacement therapy with estrogen or testosterone is often the conventional treatment for hypogonadism. Natural ways to boost these hormones include diet, exercise, and stress reduction.
A Word From Verywell
Declining estrogen and testosterone can impact your sex life, put you at risk of cardiovascular disease, and affect your mood and how you look at yourself in regard to gender. If you are experiencing symptoms of hypogonadism see a healthcare professional immediately.
They can diagnose and treat underlying conditions that can lead to hypogonadism and assess whether or not you are a candidate for hormone replacement therapy. This can get you back on track towards living a happy and healthy life.
Frequently Asked Questions
- How effective is alternative hypogonadism treatment?
Alternative forms of hypogonadism treatment are not a promise of a cure, but they may be helpful in conjunction with standard or conventional treatment. Lifestyle changes are never a bad idea because they decrease the risk of developing other medical conditions that may exacerbate your hypogonadism.
Before starting any supplements or taking vitamins, consult your healthcare professional to avoid unforeseen side effects, adverse reactions, and medical complications.
- Should men take natural testosterone supplements?
Many natural testosterone supplements are not approved by the Food and Drug Administration (FDA). In addition, the little-studied ingredients contained in many of these supplements may be detrimental to your health.
Even more, they may have too much or too little testosterone, making their impact hit or miss at best. Ask your doctor or healthcare professional about acceptable ingredients and never start a new drug without medical consultation.
When considering natural supplements, you may wish to work with a naturopathic doctor (ND), licensed acupuncturist (LAc), or doctor of Oriental medicine (OMD), or other natural and functional medicine practitioners who can work in tandem with medical doctors (MD) and offer supplements that have been verified.
- Are estrogen supplements safe?
Like testosterone supplements, off-market and non-prescribed estrogen supplements may be unsafe and ineffective. Ask your doctor or healthcare professional about acceptable ingredients and never start a new drug without medical consultation.
- What do researchers know about hormone replacement therapy?
HRT is a proven method to increase estrogen and testosterone therapy but not all people are candidates. For example, estrogen can increase your risk of getting a blood clot; therefore, those with a history of blood clots are not candidates for HRT.
People with a history of cancer or high cancer risk are not recommended to take estrogen, which may increase their cancer risk. When considering HRT be sure to have a thorough discussion with a trusted healthcare professional to review the risks and benefits of therapy.