IASH India: Institute of Andrology & Sexual Health India
  • Hypogonadism: Types, Causes, Symptoms & Treatment

    Hypogonadism Meaning

    Hypogonadism has two terms: hypo and gonads. We usually add hypo prefixes to mention something that is less than normal or low. Whereas Gonads is the term referring to men’s and women’s primary reproductive organs. Not to mention, the important feature of gonads is that they produce gametes for further sexual reproduction.

    So putting both terms together we get hypogonadism, which means low-performing sexual organs or more specifically low-level testosterone or andropause.

    • Gonads in male: Testes
    • Male gametes: Sperms
    • Gonads in females: Ovaries
    • Female gametes: Eggs
    • MEANING IN HINDI: अल्पजननग्रंथिता

    As men and women go old, they both experience sexual maturity that may vary in signs and symptoms. Andropause, erectile dysfunction, male infertility, other Ejaculation Problems like Premature Ejaculation, Retrograde Ejaculation, sexual difficulties, osteoporosis, and low libido are some issues that are regular in growing age and are mainly because of falling testosterone levels in men.

    To get the best treatment for Male Hypogonadism disorder IASH India prescribes some laboratory tests, imaging, therapy, and follow-ups. In the case of congenital diseases like testes problems or foreskin problems and other testicular problems like varicocele.

    Androgen and Testosterone

    Hormones are chemical messengers produced by glands and then blood carries them to other organs in the body. We primarily need hormones for reproduction, whereas the growth and well-being of the human body are secondary.

    Androgens are male sex hormones that increase at puberty and are required for a boy to develop into a sexually mature adult who can reproduce. The most noteworthy androgen a male body cares about is testosterone.

    The testosterone hormone is a byproduct of the testes. Moreover, the walnut-size adrenal glands sitting on top of the kidneys also make a small amount of testosterone.

    Understand Hypogonadism :IASH India

    Hypogonadism In Male

    • Hypogonadism in Male is when there is testosterone deficiency in the body.
    • Low testosterone levels can be congenital or acquired.
    • It can be a primary hypogonadism-testes problem or low response to hormonal stimulation.
    • Hypogonadism can be a pituitary or hypothalamus glands problem, also referred to as secondary hypogonadism.
    • In males, it can hamper testicular development in men.

    Hypogonadism In Females

    • Hypogonadism occurs in the female body when glands produce little or no hormones
    • Women’s ovaries mainly produced these required hormones like estrogen, testosterone, and progesterone.
    • Hypogonadism in females hampers feminity low breast development in women and pubic hair growth for instance.

    Signs of Low Testosterone Levels In Men

    Medical problems, genetic disorders, or problems with the testes or pituitary gland can cause hypogonadism. When the testes or other glands cannot produce sufficient hormones in the brain, the problem of low testosterone or andropause occurs. Klinefelter’s syndrome is a common chromosomal disorder that is much known for causing testosterone deficiency. The other main causes of Hypogonadism or low testosterone are Seven Reasons For Why Men In India Have Low Testosterone Levels. 

    • Too much use of polycarbonate plastic

    One of the most shocking causes of low testosterone levels is an increase in the consumption of plastic. Plastic bottles, disposable we use, have polycarbonate plastics containing the chemical bisphenol A. This chemical is the largest contributor to low testosterone levels. Surprisingly, it was found that over 80% of infertile men have an adequate amount of bisphenol A or BPA in their urine.

    In context to it, the use of plastic is impeding male sexuality as BPA lowers testosterone levels in men, as well as the levels of another hormone androgen, known as androstenedione.

    • Overweight or Obesity

    The second reason for low testosterone levels is being overweight. Fat or obese man has adipose tissue which easily activates aromatase. Enzyme generates a biochemical reaction in the body and aromatase enzymes ideally convert testosterone to estrogen. In other words more fat in the body — more aromatase enzymes—-more estrogen and low testosterone levels.

    Another point to consider is that being overweight increases the risk of diabetes. Diabetes is also culpable for decreased testosterone levels. Few exercises like kegel and yoga can help to reduce weight and improve sexual performance according to the expert.

    • Reduced Sleep

    The third reason for low testosterone levels is poor sleep. Reduced sleep forms stress in the body and thus increases cortisol levels. Cortisol hormone is the culprit for low sex drive.

    So far we have heard that waking up early in the morning is good for health but studies have shown that reducing one’s sleep in the second half of the night, which means we wake up earlier than normal, can affect testosterone levels in the male body.

    • Protein Soy Food

    The fourth reason for low testosterone levels is wrong food habits. Now there are certain food habits that can affect testosterone levels. For instance, we require vitamins and minerals for testosterone production, whereas soy protein or soy food can actually reduce testosterone levels.

    Ironically, soy has a similar structure to estrogen and can suppress the levels of testosterone. A low-fat diet, and deficiency of Zinc, Vitamin E, and vitamin C also reduce testosterone levels.

    • Stress

    The fifth common reason for low testosterone levels in Indian men is stress. As stress increases, the cortisol hormone levels increases. Cortisol level act on the brain to increase levels of estrogen, ultimately leading to reduced testosterone levels.

    • Excessive Alcohol Consumption

    The sixth possible reason for low testosterone levels is excessive alcohol consumption. As we know, beer is estrogenic, regulating the heart and blood vessels, and pelvic muscles. The phytoestrogen and prolactin found in barley and hop, key ingredients of beer, increase estrogen and reduce levels of testosterone.

    • Low libido or low sex drive

    And the seventh reason for a low testosterone level is asexuality. Now, the low testosterone levels actually can lead to a lower desire for sex or lower libido, and lower libidos can actually lead to lower testosterone levels – so it’s a vicious circle of cause and effect. Usually men above 40 experience a natural fall in sex drive, eventually building low testosterone levels in the body.

    Hypogonadism Diagnosis At IASH India

    A diagnosis of hypogonadism involves having a thorough medical evaluation and at least two blood samples (taken in the morning on different days) to measure testosterone hormone levels.

    We don’t diagnose only on the basis of symptoms as the sign of low testosterone level as it can be also because of other health problems that need different treatment. Only when blood tests show a lower than normal testosterone level, then we confirm the signs of hypogonadism.

    At IASH, experts or doctors will diagnose hypogonadism through the following process:

    • We will first check your testosterone hormone levels.
    • Then will need a blood test to check your level of follicle-stimulating hormone (FSH) and luteinizing hormone.
    • After, you will then keenly examine your pituitary gland to ensure they are making enough reproductive hormones.
    • In the case of female hypogonadism, we can also ask for an estrogen level test.

    Hypogonadism Treatment

    Testosterone therapy(TT) is the best treatment for hypogonadism; TT therapy means giving testosterone in doses that return the testosterone levels in the blood to normal. However, Dr. Chirag Bhandari prescribed hormone replacement therapy for men with Hypogonadism only confirmed by blood tests. Testosterone therapy(TT) is regular for life for better and more successful results.

    The other treatment for Low testosterone levels or hypogonadism are:

    • Medications

    Medical compositions like L- arginine, Tribulus Terrestris mixed with natural and herbal plants, Ashwagandha, and Tongkat Ali Horny Goat Weed helps to build the sexual drive and raise testosterone levels in the male body.

    Testosterone therapy is available as injections, gels, creams, patches, and tablets, and works very well for men with confirmed (testosterone) deficiency. The type of hypogonadism treatment prescribed can depend on patient convenience, familiarity, and cost. Commercial testosterone products have only the natural testosterone molecule that is natural plant chemicals.

    • Hormone and Estrogen modulator

    Another key point, it is not always rational to apply testosterone therapy(TT) or give additional testosterone to a man suffering from hypogonadism, as doing that can actually decrease his sperm count as a side effect. So the best sexologist in Jaipur Dr. Chirag Bhandari prescribes a low dose of selective estrogen receptor modulator(SERM) Instead of prescribing testosterone to treat male factor infertility.

    • Self-care

    Eating a lot of vegetables and avoiding soy products can help to maintain adequate testosterone levels naturally. Men who are regular with their sleep patterns and remain happy enjoy good levels of testosterone for a longer period of time.

    • Weight loss

    As we already discussed, being overweight is one of the possible causes of low levels of testosterone, hence regular exercise and keeping weight in check is a preventive measures to avoid hypogonadism.

    Hypogonadism Symptoms

    Low energy levels, mood swings, irritability, poor concentration, reduced muscle strength, and low sex drive can be symptoms of hypogonadism or low testosterone level. Symptoms often overlap with those of other illnesses. The symptoms of testosterone deficiency are different for men of different ages.

    Over time, men with hypogonadism can develop:

    • Erectile dysfunction(स्तंभन दोष)
    • Infertility
    • Loss of bone mass (osteoporosis)
    • Reduced muscle mass.
    • Growth of breast tissues (gynecomastia)
    • Lessening of hair growth on the face and body.

    On closely evaluating symptoms of hypogonadism, Dr. Chirag Bhandari says there are two types of hypogonadism primary and secondary

    • Primary hypogonadism

    When the testes have a problem in producing hormones, it is primary hypogonadism. To understand it in a simple way Dr. Chirag Bhandari explains that when your gonads can receive a message from the brain to produce hormone but fail in execution thus produce no sex hormones in the male body.

    Replacement of testosterone technique(HRT) is the best treatment for Primary hypogonadism.

    With this technique, IASH provides medications to increase levels of testosterone, progesterone, pituitary hormones, or estrogen to meet body deficiency.

    • Secondary hypogonadism

    The malfunctioning of pituitary glands in the human brain that signal gonads to produce hormones causes secondary hypogonadism.

    Unlike primary hypogonadism, the gonads are performing well but they are not receiving signals from the brain. This disconnection leads to a deficiency of testosterone levels in the male body.

    The pituitary glands of the brain that signal the male gonads or testicles to produce testosterone are the hypothalamus. We often refer secondary hypogonadism to as hypogonadotropic hypogonadism (HH).

    Difference between primary and secondary hypogonadism 

    Primary Hypogonadism – low levels of testosterone and high-normal to high levels of LH and FSH.

    Secondary hypogonadism – low levels of testosterone and normal to low levels of LH and FSH.

    ICD 10 for Hypogonadism

    ICD is the International Classification of Disease. It set international standards in classifying disease injuries and causes of death.

    United States follows ICD-10-CM which allows certain treatments under insurance cover. Primarily, this code shows a diagnosis for reimbursement in case of death after a particular treatment

    ICD 10 code for hypogonadism is E29. 1. Hormone replacement therapy


    In the Final analysis, sexual desire is different for each person and may change over time, depending on what is happening in a person’s life, and we may not see low libido as a problem for some men. However, if a man worries about losing interest in sex for no obvious reason, then talking to a doctor may be helpful.

    For the most part, the hormone that is necessary for fabricating sexual desire is testosterone. It is testosterone that makes the muscles and bone mass solid for pleasurable sex, and testicles mostly produce it.

    In a word, you must consult a male sexual health specialist(Andrologist) at IASH Jaipur for low testosterone levels of hypogonadism treatment in Jaipur. It is important to rule out any physical cause for the same by taking a detailed sexual history, physical examination, and doing some blood tests.

    In case, if there is no physical cause, it is important to consult a clinical psychologist who has experience in treating signs of low testosterone.

    Frequently Asked Questions

    Q1. What is the ‘normal’ testosterone range?
    The ‘normal’ testosterone reference range for healthy, young adult men is about 8 to 27 nanomolar but these numbers vary between measurement systems.

    Q2. What is the treatment of hypogonadism?
    Testosterone therapy is the best treatment for hypogonadism; this means giving testosterone in doses that return the testosterone levels in the blood to normal. We prescribe testosterone for men with androgen deficiency confirmed by blood tests. Moreover, we usually continue testosterone therapy for life, with regular checkups by a doctor.

    Q3. What are the side effects of testosterone therapy?
    Generally speaking, there are no side effects because testosterone therapy aims to bring a man’s testosterone levels back to normal. However, testosterone therapy can increase the growth of the prostate gland, which can make the symptoms of benign prostate enlargement (such as needing to urinate more often) worse.

    Q4. Can herbal products help testosterone deficiency?
    There are many herbal products, particularly on the Internet, as treatments that can act like testosterone and improve muscle strength and libido (sex drive). However, there are no known herbal products that can replace testosterone in the body for hypogonadism treatment.

    FAQs - Dr. Chirag Bhandari

    Frequently Asked Questions

    Q1. Who is Sexologist Doctor?

    A1. A sexologist is a medical professional who specializes in the field of sexual health. I am Dr. Chirag Bhandari, a sexologist, and I have dedicated my career to diagnosing and treating various sexual health issues.

    Q2. How to identify a Best Sexologist?

    A2. To identify a top sexologist, consider their credentials, experience, specialization, patient reviews, and your personal comfort. I have extensive experience in treating sexual health issues and am dedicated to providing the best care possible.

    Q3. Why Choose Dr. Chirag Bhandari for the treatment of your Sexual Problems?

    A3. Choosing Dr. Chirag Bhandari means choosing a dedicated and experienced sexologist who is committed to addressing your sexual health concerns. My clinic provides personalized care and effective treatment options.

    Q4. What is the Consultation Fee at Dr. Chirag Bhandari's Clinic?

    A4. Consultation fees at my clinic may vary. Please contact my clinic directly for specific information about fees and payment options.

    Q5. What is the duration of time slot for a Consultation at Dr. Chirag Bhandari's Clinic?

    A5. The duration of a consultation can vary depending on the nature of your concerns. Initial consultations may take longer as we gather essential information about your condition.

    Q6. Do I pay every time I undergo a Consultation?

    A6. Consultation fees are typically charged for each visit. However, we may offer package deals or discounts for multiple consultations. Please inquire at the clinic for more details.

    Q7. Do I need to Book an Appointment on the Scheduler of Website for an Online Consultation?

    A7. Yes, for online consultations, it is advisable to book an appointment through our clinic's website scheduler. This helps ensure you receive dedicated time for your consultation.

    Q8. I wish to proceed with an Online Consultation, what are the Steps ahead?

    A8. To proceed with an online consultation, visit our clinic's website and use the appointment scheduling system to book a convenient time. You'll receive further instructions via email or phone.

    Q9. Can masturbation have a negative impact on my overall health?

    A9. Masturbation is generally considered a normal and healthy sexual activity. However, excessive or compulsive masturbation may lead to physical or psychological issues. It's essential to maintain a balanced approach to ensure it doesn't interfere with your well-being.

    Q10. Is Sexual Disorders common?

    A10. Yes, sexual disorders are relatively common, and they can affect people of all ages. It's essential to seek professional help if you're experiencing any sexual health concerns.

    Q11. What are the Sexual problems that you Providing the treatment in clinic?

    A11. I provide treatment for a wide range of sexual problems, including but not limited to erectile dysfunction, premature ejaculation, low libido, sexually transmitted infections, and more. Feel free to discuss your specific concerns during the consultation.

    Q12. How long does it take to get rid of premature ejaculation or Erectile Dysfunction?

    A12. The duration of treatment for premature ejaculation or erectile dysfunction varies depending on the individual's condition and the chosen treatment plan. It can take several weeks to several months to see improvements. We'll discuss this during your consultation.

    Q13. I am suffering with Penile Infections/ Balanitis/ Balanoposthitis/ STDs/ STIs/ Phimosis/ Paraphimosis.

    A13. Penile infections and related conditions require careful evaluation and treatment. I can help diagnose and provide appropriate treatment options based on your specific condition during a consultation.

    Q14. I am suffering with Sexual Dysfunction, what do I expect in my consultation?

    A14. In a sexual dysfunction consultation, you can expect a thorough assessment of your medical history, a physical examination, and a discussion of your symptoms and concerns. We'll work together to create a personalized treatment plan.

    Q15. What is a Level 1 Consultation for patients suffering with Sexual Dysfunction?

    A15. The meaning of "Level 1" consultations can vary. At my clinic, a Level 1 consultation may involve an initial assessment and diagnosis of your sexual dysfunction. Specific details will be provided during your visit.

    Q16. What is a Level 2 Consultation for patients suffering with Sexual Dysfunction?

    A16. A Level 2 consultation may involve a more in-depth assessment, additional testing, or a review of your progress. This level is determined based on your specific needs and the nature of your condition.

    Q17. I have already had so many bad and failed experiences with previous Clinics/ Doctors in my City/ Country, how do I trust Dr. Chirag Bhandari?

    A17. I understand your concerns. Trust is essential. I am dedicated to providing the best care possible, and I encourage you to read patient reviews and testimonials to gain confidence in my expertise. My goal is to help you achieve the best results.

    Q18. What are all the payment options available at Dr. Chirag Bhandari's Clinic?

    A18. We accept various payment options, including cash, credit/debit cards, and health insurance in some cases. Please inquire at the clinic for specific details about payment methods.

    Q19. Is the Consultation Fee/ Online Assessment Fee/ Treatment Fee Refundable or Transferable?

    A19. The refund and transfer policies for consultation fees, online assessments, and treatment fees can vary. Please discuss these policies with our clinic staff to understand your options.

    Q20. Can I get an approximate idea of the cost of the treatment?

    A20. The cost of treatment can vary widely depending on the specific condition and the treatment plan. We'll discuss treatment costs during your consultation, and our team will provide you with an estimate based on your individual needs.