Hypogonadism: 6 Natural Ways to Support Hormonal Treatment - Dr. Axe

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Hypogonadism Causes + 6 Ways to Help Balance Hormone Levels


Hypogonadism - Dr. Axe

If you or a loved one is struggling with hypogonadism, you may already know that it can be a devastating condition that reduces your quality of life and livelihood. People with hypogonadism can experience muscle loss, low libido, infertility and depressed mood. In fact, these symptoms can make talking about hypogonadism difficult. (1)

Thankfully, research shows that there are ways to balance your hormones, either using hormone replacement therapy, which is the conventional form of treatment for this condition, or natural estrogen and testosterone boosters like exercise, dietary and lifestyle changes, adaptogen herbs and essential oils. But if you’ve been struggling with the symptoms of hypogonadism, rest assured that there are natural remedies to help support your treatment and improve your quality of life.

 What Is Hypogonadism?

Hypogonadism is a condition that occurs when the body’s sex glands, the testes for males and ovaries for females, produce little or no hormones. For males with hypogonadism, low testosterone can affect the development and maintenance of male reproductive organs, including the testes, penis and prostate. In fact, low testosterone levels can lead to issues like reduced muscle strength, hair loss and impotence.

For females, hypogonadism occurs when the ovaries aren’t producing enough estrogen. Estrogen is responsible for maintaining sex organs like the uterus, vagina, fallopian tubes and mammary glands. But low or little estrogen in the body can lead to infertility, loss of libido, mood swings, loss of menstruation and osteoporosis. (2)

There are two types of hypogonadism, primary or central, or secondary. The definition of these types of hypogonadism depends on the cause of the condition.


Primary hypogonadism: Primary hypothyroidism occurs when there’s a problem in a person’s testes or ovaries, which are the gonads. The gonads are receiving messages from the brain to produce hormones, but they aren’t functioning properly.

Central hypogonadism: In central, or secondary hypogonadism, it’s the centers in the brain that aren’t working properly. The hypothalamic and pituitary glands control the gonads and the release of hormones, but with central hypogonadism, something is causing these glands in the brain to malfunction. This leads to decreased levels of luteinizing hormone and follicle stimulating hormones, which are normally stimulated by the gonads. (3)

Signs & Symptoms

The symptoms of hypogonadism vary depending on the patient’s age, sex and type of condition.

Symptoms in Females: Women with hypogonadism may experience the following symptoms:
  • decreased sex drive
  • loss of menstruation
  • loss of body hair
  • hot flashes
  • infertility
  • vaginal dryness
  • osteoporosis
  • fatigue
  • depressed mood
  • mood changes and irritability
  • headaches

If a young girl has hypogonadism, she may not menstruate. Plus the condition can affect her height and breast development.

Symptoms in Males: Men with hypogonadism or low testosterone may experience the following symptoms (4):
  • muscle loss and weakness
  • decreased body or facial hair
  • decreased sex drive
  • erectile dysfunction
  • infertility
  • breast enlargement (called gynecomastia)
  • osteoporosis
  • fatigue
  • depressed mood
  • headaches

Boys with low testosterone may have growth problems, with a delay in muscle growth and beard development, impaired testicle and penis growth, and enlarged male breasts. Also, low testosterone levels may result in failure of normal pubertal progression.

Causes & Risk Factors

The cause of hypogonadism depends on the type of condition, either primary or central.

Primary hypogonadism can be caused by any of the following health conditions or factors (5):

  • certain autoimmune disorders
  • chromosomal abnormalities
  • genetic disorders, such as Turner syndrome in women and Klinefelter syndrome in men
  • liver and kidney disease
  • an infection
  • surgery on the sex organs
  • radiation or chemotherapy
  • injury to the gonads
  • undescended testes, which occurs when the testicles don’t move down into the scrotum after birth
Central hypogonadism (also known as hypogonadotropic hypogonadism) occurs when there’s an issue with the centers of the brain that control hormone production. The following issues can cause it:
  • nutritional deficiencies
  • pituitary disorders
  • inflammatory diseases, like tuberculosis and sarcoidosis
  • Kallmann syndrome, which affects the hypothalamus
  • certain medications, like opiates and glucocorticoids
  • infections, like HIV/AIDS
  • anorexia nervosa
  • injury to the hypothalamus or pituitary gland
  • surgery, such as the removal of a brain tumor
  • radiation or chemotherapy
  • a tumor in or around the pituitary gland
  • rapid weight loss
  • obesity
  • normal decline of hormones with age

Androgen deficiency of the aging male (known as ADAM) is a cause of secondary hypogonadism. ADAM occurs when a man’s testosterone levels decline progressively after age 40, leading to sexual dysfunction and altered body composition, cognition and metabolism. (6) In fact, research published by the International Journal of Clinical Practice indicates that older men are more likely to have low testosterone levels, with the prevalence being 34 percent in men between the ages of 45 and 54, and 50 percent in men over 85 years. (7)

According to research published in the International Journal of Clinical Practice, hypogonadism is significantly associated with various health issues, including Type 2 diabetes, hypertension, obesity, osteoporosis and metabolic syndrome. (8)

What is hypogonadism? - Dr. Axe

Conventional Treatments

Treatment for hypogonadism depends on the cause of the condition. But the most common form of treatment is hormone replacement therapy, which is used to restore hormone levels to the normal range.

For Females: Women with hypogonadism are usually given a combination of estrogen and progesterone. However, research shows that estrogen therapy can increase the risk of heart disease, blood clots and cancer. Progesterone is added to estrogen therapy because it may reduce the risk of endometrial cancer.
A 2016 study published in Nature Reviews Endocrinology indicates that, according to the most recent data, hormone replacement therapy significantly decreases the incidence of various symptoms of low estrogen, including the risk of osteoporosis fractures. (9) However, researchers do point out that estrogen therapy does come with potential risks. These risks include a higher risk of cardiovascular disease and breast cancer, which need to be taken into consideration. (10)
For Males: Testosterone replacement therapy is used to improve libido, erectile function, cognition, muscle strength and mood. Studies show that once testosterone levels are restored with testosterone replacement therapy, over a period of six months, there is a reduction in body fat and an increase in lean body mass. Research has also shown that treatment can improve insulin resistance. This is believed to be the result of fat mass reduction after testosterone therapy. (11)
But there are also risks of adverse side effects when using testosterone replacement therapy, including worsening prostate health, like enlarged prostate (BPH) and prostate cancer, skin disorders like acne and skin irritation, decreased bone density and worsening of sleep apnea. (12) There’s even a possible increased risk of cardiovascular disease, according to research conducted at the University of Washington. (13)

6 Natural Ways to Support Hypogonadism Treatment

1. Reduce Stress

A study conducted at the University of Massachusetts Medical School investigated the association between testosterone levels and stress. Researchers measured the stress levels of participants by taking into account daily hassles, major life events and perceived stress. They found that testosterone levels were significantly associated with stress in both males and females. This study suggests that testosterone levels are reflective of a person’s ability to respond to stressors and his or her emotional coping mechanisms. (14)

To support your treatment for hypogonadism, practice some simple stress relievers, like spending time outdoors, meditating, exercising, being social and keeping a journal. Pursuing some form of therapeutic practice, like cognitive behavioral therapy, may also be beneficial because it helps you to better react to stressful situations. Plus, vocalizing your fears and emotions about coping with hypogonadism can be extremely helpful.

2. Address your Weight and Diet

Being overweight and being underweight can both contribute to low sex hormone levels. For the majority of people, before they can maintain a normal body weight to help regulate their hormone levels, they need to change the way they eat. This may be the most important natural remedy to help treat hypogonadism. (15)

In fact, a 2014 study published in the Journal of Neuroinflammation found that low testosterone and diet-induced obesity can contribute to impairments in neural health, increasing the risk of serious disorders like type 2 diabetes and Alzheimer’s disease. (16) There’s also a childhood obesity epidemic that is causing serious health issues among children, including problems with growth and development.


So if you have low testosterone and you’re struggling with weight loss, now is the time to make some serious changes to your diet in order to get well.

First, cut out all of the junk food, the processed, packaged and fast food, the refined carbohydrates and the artificial sweeteners. Focus on eating whole, real foods, including the following:

  • healthy fats, like coconut oil, olive oil, fermented dairy products, avocados, almonds, walnuts, chia seeds and flax seeds
  • organic protein, like wild-caught salmon, organic chicken and grass-fed beef
  • fresh fruits and vegetables, like berries, leafy greens, broccoli, celery, carrots and artichokes
  • high-fiber foods, like figs, squash, nuts, seeds, beans and legumes

If you are having trouble staying on track with your diet and eating healthy, consider working with a health coach who can serve as a mentor and help you to reach your weight and health-related goals.

3. Exercise Regularly

There’s plenty of research that proves exercise can regulate or boost low testosterone levels. In fact, one study published in the Indian Journal of Physiology and Pharmacology found that even short-term exercise produces an elevation in serum testosterone levels in adults. (17)

Some of the best forms of exercise to boost testosterone and human growth hormone levels are weight training and high intensity interval training (HIIT workouts). Research shows that even moderate and light weightlifting can increase serum testosterone levels when compared to not doing any exercise at all. (18)

Try lifting weights for at least 30 minutes, three times a week. Doing this in combination with burst training can be even more beneficial in helping to elevate your testosterone levels. Burst training means that you are exercising at 90–100 percent of your maximum effort for short, bursts of time (about 30 to 60 seconds), followed by a period of low impact exercise for recovery.

Exercise can also be helpful for women with hypogonadism because it helps to reduce stress and helps you to get to a normal weight. Weighing too little or being overweight are both factors that may cause low estrogen levels. Low-impact exercises like yoga and pilates can be very beneficial in helping to relieve symptoms and reduce some causes of hypogonadism.

4. Supplement with L-arginine

L-arginine is a type of amino acid that we obtain from our diets. It has multiple benefits, including its ability to stimulate the production of growth hormones, correct impotence, and improve erectile dysfunction and male infertility. A study published in The Journal of Endocrinology found that dietary arginine is actually required for the anabolic action of androgens, like testosterone. (19)

Research also shows that L-arginine ingestion enhances growth hormone response, increasing resting human growth hormone (HGH) levels by at least 100 percent. This is beneficial for men with hypogonadism because HGH is a natural testosterone booster. (20)

The best way to help your body make and use more L-arginine is by eating a diet based on whole, real foods, including organic grass-fed beef, wild-caught salmon, cage-free eggs, cultured yogurt, nuts and seeds, sea vegetables and coconut meat.

To supplement with L-arginine in order to improve hypogonadism symptoms, I recommend you take 3–6 grams per day, divided into two doses.

5. Try Ashwagandha

According to research published in Evidence-Based Complementary and Alternative Medicine, ashwagandha has been used in Ayurvedic medicine as an aphrodisiac that can treat male sexual dysfunction and infertility. Researchers involved in a pilot study found that patients with a low sperm count who were using ashwagandha had a 167 percent increase in sperm count, 53 percent increase in sperm volume and 57 percent increase in sperm motility. The ashwagandha group also showed improved serum hormone levels compared to the placebo group. (21)

To use ashwagandha to boost your libido, improve your hormone levels, increase your endurance and improve your mood, I recommend supplementing with 500 milligrams, one to two times daily. But do this in combination with eating a diet filled with healthy fats, fiber and clean protein.

6. Use Essential Oils

Two essential oils that can help to regulate hormone levels and improve hypogonadism symptoms are clary sage and sandalwood.

Clary sage contains natural phytoestrogens, so it helps to balance estrogen levels. According to a 2017 study published in Neuro Endocrinology Letters, clary sage can be used to alleviate menopausal symptoms caused by declining levels of estrogen secretion. In fact, researchers found that some essential oils, including clary sage, were able to increase estrogen concentration. (22) To use clary sage oil to support your hypogonadism treatment, combine 5 drops with a ½ teaspoon of coconut oil and massage the mixture into your abdomen, wrists and bottoms of your feet.

Sandalwood essential oil can be used to relieve hypogonadism symptoms, like low sex drive, moodiness, stress and cognitive issues. A 2015 study conducted at South Dakota State University shows that sandalwood also has anticancer mechanisms because of its antioxidant and anti-inflammatory properties. Researchers found that sandalwood has anticancer effects against both breast and prostate cancer. (23) You can diffuse 5 drops of sandalwood at home, inhale it directly from the bottle or apply 2–3 drops to the bottoms of your feet.


Talk to your doctor about the risks and benefits of hormone replacement therapy. There are studies supporting the benefits of hormone replacement therapy, and evidence opposing its use for hypogonadism.

Use the natural remedies discussed in this article to support your treatment for hypogonadism or to naturally boost your low estrogen or testosterone levels. However, make sure that you discuss any supplements that you choose to take with your doctor.

Final Thoughts on Hypogonadism

  • Hypogonadism is a condition that occurs when the body’s sex glands — the testes for men and ovaries for women — produce little or no hormones.
  • There are two types of hypogonadism, primary and central (also known as secondary). The definition of these types of hypogonadism depends on the cause of the condition.
  • Primary hypothyroidism occurs when there’s a problem in a person’s testes or ovaries, which are the gonads.
  • In central, or secondary hypogonadism, it’s the centers in the brain that aren’t working properly.
  • Generally, the symptoms of hypogonadism include low libido, loss of body hair, infertility, osteoporosis, fatigue and mood changes.
  • Hypogonadism is caused by a number of factors, such as an infection, nutritional deficiencies, pituitary disorders, inflammatory diseases, eating disorders, brain injury, trauma and chemotherapy.
  • The most common conventional treatment is hormone replacement therapy. There are also ways to support your treatment naturally with dietary and lifestyle changes, exercise, L-arginine and ashwagandha supplements and essential oils.

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