Is Your Sex Drive Low From Thyroid Disease?

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According to a study in JAMA, about 40 percent of women and 31 percent of men between the ages of 18 and 59 experience sexual dysfunction. While there are a number of potential causes for sexual problems, thyroid disease is a common culprit. 

How many people with sexual dysfunction may actually have undiagnosed thyroid disease is not a question that has been thoroughly researched. It's certain, though, that some of the people with sexual dysfunction could, in fact, resolve or improve these problems, simply by having their thyroid function treated.

Let's explore the sexual dysfunction in more detail, as well as its link to the thyroid, and effective solutions.

Risk Factors

Besides thyroid disease, keep in mind, that there are a number of factors that increase a person's chance of developing sexual dysfunction. For men, some of these include:

  • Cardiovascular disease
  • Diabetes
  • Obesity
  • Smoking, alcohol, and/or opioid use
  • Neurological disorders (for example, stroke or multiple sclerosis)
  • Bicycling
  • Testosterone deficiency
  • High prolactin levels 
  • Medications (for example, antidepressants, especially selective serotonin reuptake inhibitors)
  • Depression
  • Stress, trauma, and/or relationship problems

For women, some of these risk factors (besides thyroid disease) include:

  • Pelvic organ prolapse
  • Urinary incontinence
  • Endometriosis
  • Uterine fibroids
  • Menopause
  • High blood pressure
  • High prolactin levels 
  • Neurological diseases (for example, multiple sclerosis or epilepsy)
  • Obesity
  • Tobacco, alcohol, and opioid use
  • Medications (for example, antidepressants and some hormonal contraceptives)
  • Depression
  • Poor body image
  • Stress, trauma, and/or relationship problems

Symptoms

Both men and women can experience sexual dysfunction. Generally, there are four different types:

  • Lack of desire or interest in sexual activity
  • An inability to become aroused
  • An inability to orgasm or very slow to orgasm
  • Pain during intercourse

More specifically, the signs and symptoms of sexual dysfunction in men include:

  • An inability to get an erection
  • Difficulty maintaining an erection, known as erectile dysfunction (ED)
  • An inability to ejaculate or inability to control the timing (premature ejaculation or delayed ejaculation)

And, in women, the signs and symptoms of sexual dysfunction include:

  • Inadequate lubrication
  • An inability to relax the vaginal muscles
  • An inability to have an orgasm

Diagnosis

If you have not been diagnosed with thyroid disease, but are experiencing sexual dysfunction, a thyroid evaluation should be performed as part of your medical workup.

If you have already been diagnosed with thyroid disease and are experiencing sexual dysfunction, your first step should be to ensure that your thyroid treatment is optimized.

Besides investigating your thyroid health, other elements of your medical workup for sexual dysfunction include:

  • A complete medical and sexual history 
  • A physical examination, including a pelvic examination in women and a pulse examination in men
  • Evaluation of other hormones besides thyroid, including testosterone in men and prolactin in men and women
  • Review of medications, supplements, and herbal remedies being taken
  • Review of social history, including use of tobacco, alcohol, or illegal drugs
  • A discussion with your practitioner about possible psychological factors, such as stress, relationship problems, fear, and sexual trauma

Treatments

Treatment of sexual dysfunction in men and women first entails treating the underlying condition, followed by adopting lifestyle changes, and possibly, taking a medication. 

Optimize Treatment of Underlying Condition

Treating the "why" behind your sexual dysfunction (if one can be pinpointed) is key. This means, for instance, achieving good sugar control if you have diabetes or stopping a suspected drug culprit (under the guidance of your doctor). 

If you have hypothyroidism, make sure your thyroid drug treatment is optimized. You may find that sexual dysfunction is improved when your TSH level is at the lower range of "normal" than the middle or higher range. 

Make Lifestyle Changes

Research has shown that sexual dysfunction in both men and women can benefit from weight loss. Losing weight is easier said than done, of course, but excess weight can affect self-image and make you feel less sexy and less interested in sex.

Medically, being overweight can reduce sex drive. Specifically, losing weight reduces levels of sex hormone binding globulin (SHBG), which then leaves you with more free circulating estrogen and testosterone to help with your hormonal balance and sex drive.

Exercise can also be helpful by improving blood flow to all your body parts. Research has found that people who exercise regularly have higher levels of desire, greater sexual confidence and frequency, and an enhanced ability to be aroused and achieve orgasm, no matter what their age.

The best type of exercise is aerobic exercise because it can trigger the release of endorphins, which are chemicals in the brain that create a feeling of well-being.

Finally, sex therapy and or other forms of therapy with trained counselors may also be useful in dealing with any psychological issues involved like performance anxiety or poor body image. 

Men

Prescription medications may be necessary to treat sexual dysfunction in men. The first-line treatment for erectile dysfunction is a phosphodiesterase-5 (PD-5) inhibitor, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). For men with low testosterone levels, treatment with testosterone replacement therapy (in addition to a PD-5 inhibitor) can be highly effective. 

Some men may benefit from vacuum devices and implants that help with erectile dysfunction. Rarely, surgery for a penile prosthesis is needed to treat erectile dysfunction. 

Women

For postmenopausal women whose symptoms (for example, night sweats) contribute to sexual dysfunction, hormone treatment with estrogen/progestin is reasonable. Vaginal dryness and associated pain with sex may be treated with vaginal lubricants, vaginal estrogen, or Osphena (ospemifene). 

Some women with low sexual desire benefit from testosterone therapy, although testosterone is not FDA-approved due to a lack of research on long-term safety. If recommended, doctors frequently will prescribe testosterone in a cream or gel form that can be absorbed through the skin. 

Addyi (flibanserin) is a medication used to treat low sexual desire in premenopausal women. It may cause tiredness, dizziness, and low blood pressure, though, so be sure to talk with your doctor in detail about this drug before trying. In addition, Addyi cannot be taken with alcohol or certain medications, like Diflucan (fluconazole). 

A Word From Verywell

While thyroid disease may be one reason why you or a loved one is experiencing sexual dysfunction, there are numerous other potential causes, and often times, there is more than one contributing factor. 

Be sure to schedule an appointment with your doctor if you have any concerns about your sexual health. Try not to be nervous either—remember, your doctor is there to help you get and live well. 

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Article Sources
  • Cunningham GR, Rosen RC. (2018).Overview of male sexual dysfunction. Snyder PJ, O'Leary MP, ed. UpToDate. Waltham, MA: UpToDate Inc.
  • Laumann EO, Paik A, Rosen RC.Sexual dysfunction in the United States: prevalence and predictors.JAMA. 1999 Feb 10;281(6):537-44.
  • Shifren JL. (2018). Overview of sexual dysfunction in women: Epidemiology, risk factors, and evaluation. Barbieri RL, ed. UpToDate. Waltham, MA: UpToDate Inc.