Thyroid Disease in Men

Classic and Unique Symptoms

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Thyroid disease in men involves many of the same symptoms as those that affect women with a thyroid disorder. Men, however, may also experience some manifestations of a thyroid issue that are unique to their sex—some of which you may not immediate associate with such a concern, such as low sperm count, loss of muscle mass, and erectile dysfunction.

Many men don't consider that they could have thyroid disease, even if they present with classic symptoms. Part of the reason for that may be that women are five to eight times more likely to have a thyroid disorder than men are.

General Symptoms

For the most part, males and females experience similar symptoms when it comes to thyroid disease.

Hypothyroidism

Hashimoto's disease is the most common cause of hypothyroidism (underactive thyroid) in the United States. This autoimmune disorder results in your immune system attacking and destroying your thyroid and it tends to run in families.

General symptoms of hypothyroidism include:

  • Weight gain
  • Coarse, dry skin
  • Fatigue
  • Feeling cold
  • Constipation
  • Depression
  • Joint pain
  • Muscle aches or stiffness
  • Memory problems
  • Hair loss
  • Enlarged thyroid

Hyperthyroidism

Graves' disease, another autoimmune thyroid condition, is the most common cause of hyperthyroidism (overactive thyroid). When it's treated, you may eventually experience hypothyroidism.

The general symptoms associated with hyperthyroidism include:

  • Weight loss
  • Feeling nervous or anxious
  • Faster heartbeat
  • Heart palpitations
  • Sweating
  • Tremor
  • Increased appetite
  • Difficulty sleeping
  • Fatigue
  • Muscle weakness
  • Feeling hot
  • Enlarged thyroid

Male-Specific Symptoms

Men with thyroid dysfunction may have symptoms that are more specific to males. Among them:

  • Balding/hair loss
  • Lower sex drive
  • Decreased testosterone levels
  • Gynecomastia, male breast enlargement (hyperthyroidism)
  • Loss of muscle mass and/or strength

Sexual Dysfunction and Thyroid Disease

The thyroid impacts sexual function in both males and females, though it may be more obvious in males.

As such, men with thyroid disease may also experience these sexual health-related symptoms:

  • Erectile dysfunction
  • Delayed ejaculation (more common in hypothyroidism)
  • Premature ejaculation (more common in hyperthyroidism)
  • Problems with sperm that can lead to infertility such as lower sperm counts, poorer sperm quality, lower semen volume, and less sperm motility

A 2018 review of studies that were performed from 1978 to 2018 regarding thyroid disease and sexual dysfunction found the following:

  • In men with hypothyroidism, 59 percent to 63 percent are estimated to experience sexual dysfunction, including decreased libido, erectile dysfunction, and delayed ejaculation.
  • In men with hyperthyroidism, an estimated 48 percent to 77 percent experience sexual dysfunction, including decreased libido, erectile dysfunction, and premature ejaculation.

These are significant numbers. Thankfully, the review also found that treating the underlying thyroid disease significantly improves sexual dysfunction in both males and females. The researchers also noted that since many of the patients involved in these studies were under the age of 40, an underlying thyroid condition may be the explanation for sexual dysfunction in younger adults, particularly young men.

Diagnosis

Thyroid disease diagnosis is the same no matter your sex. Unfortunately, doctors tend to overlook thyroid symptoms in men since thyroid dysfunction is not nearly as common as it is in women. And because it usually affects men over the age of 40 and many of the symptoms are general and vague, doctors will often chalk up conditions like erectile dysfunction, decreased sex drive, balding, weight problems, and loss of energy to age.

If your doctor does suspect that you have a thyroid problem, he or she will discuss your medical history and symptoms with you, perform a physical exam, and order some blood tests to check your thyroid hormone levels.

If your doctor does suspect that you have a thyroid problem, he or she will discuss your medical history and symptoms with you, perform a physical exam, and order a TSH test to screen for thyroid disease.

Imaging Tests

In the case of suspected hyperthyroidism, you may also have imaging tests such as:

If hypothyroidism is the potential diagnosis, your doctor may order an ultrasound, but it's unlikely you'll need any other imaging tests unless he or she thinks the hypothyroidism is due to a pituitary or brain issue known as central hypothyroidism.

Treatment

Treatment depends on whether you have hypothyroidism or hyperthyroidism.

Hyperthyroidism

Treating hyperthyroidism usually begins with taking antithyroid medication. Once your thyroid gets back to functioning normally, you may be able to go off of the medication, at least temporarily, or you may need to be on it long-term.

Other treatment options include radioactive iodine ablation, which destroys your thyroid tissue, and a thyroidectomy, a surgery that removes part or all of your thyroid. Both of these treatments eventually result in hypothyroidism.

Hypothyroidism

Having hypothyroidism means that you'll be taking a thyroid hormone replacement medication, typically Synthroid, Tirosint, or Unithroid (levothyroxine), a synthetic form of T4. This will be a lifelong treatment.

If your symptoms aren't managed on levothyroxine, your doctor may add Cytomel (liothyronine), a synthetic form of T3. Another option is to take desiccated thyroid extract (DTE), a prescription medication that's made from pig thyroid and that contains both T3 and T4.

Coping

If you're having difficulties with sexual dysfunction and you've just been diagnosed with thyroid disease, be patient. As noted earlier, treating a thyroid condition drastically improves sexual issues in most people. That said, it can take a while for your thyroid to start functioning normally again.

If you find that you're still having problems with erectile dysfunction, decreased libido, delayed ejaculation, or premature ejaculation even after you've been on treatment for your thyroid, and you're feeling better otherwise, talk to your doctor about other factors that could be causing your issues.

In the event that you've already been diagnosed with a thyroid condition and you're still having difficulties, sexual or otherwise, it's possible that your treatment is insufficient. Talk to your doctor about optimizing your treatment so it's tailored to where your thyroid hormone levels should be for you individually.

A Word From Verywell

The key point to remember about thyroid disease is that it's usually, though not always, progressive. Because it can affect multiple organs in your body, it’s important to take note of any and all symptoms you experience, including emotional ones. It may be easy to attribute these symptoms to age, but most men can sense when a condition is abnormal or is getting worse.

If you think you might have thyroid disease, it's important to get it diagnosed and treated for the sake of your overall health and your quality of life. If you're experiencing sexual or erectile dysfunction, be sure to have a thorough thyroid evaluation to rule out a thyroid problem as the root of the issue. Try the American Thyroid Association's online locator to find a thyroid specialist near you.

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