Sexual Dysfunction and Thyroid Disease

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Sexual dysfunction can be caused by both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Men may develop related erectile dysfunction (ED), while women may experience painful intercourse. And low libido can occur because of thyroid disorders in either sex.

Sexual issues caused by thyroid disease often resolve once the disorder has been treated. Even problems that persist can be managed using many of the same strategies that are effective for sexual dysfunction in general.

This article discusses sexual problems associated with thyroid disease. It explains how thyroid disease can lead to erectile dysfunction and other problems. It also provides helpful coping strategies for maintaining intimacy when thyroid conditions lead to sexual dysfunction.

Sexual Dysfunction and Thyroid Disease in Men and Women
Verywell / Nusha Ashjaee

Thyroid Disease and Sexual Health

The thyroid gland produces hormones that influence virtually every cell, organ, and system in the body.

Both men and women may find that their desire for sex or even their ability to take part is affected by common symptoms of hypothyroidism, such as fatigue and depression. But thyroid disease can have a unique impact on each sex as well.

How Thyroid Disease Affects Females

Women with thyroid disease may experience:

  • Loss of sex drive: According to the American College of Obstetricians and Gynecologists (ACOG), diminished libido is a common symptom of an underactive thyroid.
  • Hypoactive sexual desire disorder (HSDD): The American Sexual Health Association (ASHA) defines HSDD as “the absence of sexual fantasies and thoughts, and/or desire for or receptivity to, sexual activity that causes the personal distress or difficulties in her relationship.” Note that this is different from low libido.
  • Painful sex: Low levels of thyroid hormone are associated with vaginal dryness, which can result in discomfort during intercourse.

How Thyroid Disease Effects Males

Men with thyroid disease may experience:

  • Erectile dysfunction (ED): The inability to get an erection or to keep one that’s firm enough for sex is thought to be a potential side effect of both hypothyroidism and hyperthyroidism. Research suggests that about 60–70% of men with thyroid disease may experience ED.
  • Ejaculation issues: Men who have hypothyroidism have an increased risk of delayed ejaculation, while those with an overactive thyroid may have an increased risk of premature ejaculation.
  • Decline in sex drive: As with women, a decrease in libido has been associated with thyroid disease, although research has shown both hypothyroidism and hyperthyroidism may have this side effect in men.

Diagnosing Thyroid-Related Sexual Issues

If you’re experiencing some type of sexual dysfunction, your healthcare provider may want to do a thyroid evaluation. This will include a blood test to measure your levels of thyroid hormone.

A 2018 study looking at ED and subclinical hypothyroidism (low thyroid hormone without symptoms) found that a significant number of men with erectile dysfunction also had the thyroid condition. The authors recommended thyroid evaluations in men with ED for this reason.

Little is known about what portion of sexual problems experienced by people overall might involve a thyroid disorder.

Treatment

Treatment for sexual dysfunction related to thyroid disease may involve starting or making changes to thyroid medication, treating the sexual issue directly, or both.

Thyroid Medications

Two of the most commonly prescribed drugs for hypothyroidism are levothyroxine, a synthetic form of the T4 thyroid hormone thyroxine, and liothyronine, a synthetic form of the T3 thyroid hormone triiodothyronine.

Levothyroxine is sold under the names Synthroid, Tirosint, and others. Liothyronine is sold under the name Cytomel. Both drugs are also available as generics.

In studies, men with sexual dysfunction problems who also had hypothyroidism experienced improvement in their sexual symptoms after levothyroxine and liothyronine.

A person who already is taking thyroid medication may have improvements in sexual function after their treatment is tweaked.

Erectile Dysfunction Medications

Phosphodiesterase-5 (PD-5) inhibitors are effective for treating erectile dysfunction and do not interact with thyroid treatments. These medications include:

Relieving Vaginal Dryness

Osphena (ospemifene) is a hormonal treatment for postmenopausal women. It targets changes in the vagina that can cause dryness and painful intercourse. It’s safe for women with thyroid disease to take.

Vaginal dryness also can be managed with an over-the-counter vaginal lubricant such as Replens.

If you’re being treated with levothyroxine and are having sexual issues, it may help to talk to your healthcare provider or endocrinologist about adjusting your dosage.

Coping

A full and satisfying sex life can be a vital component of overall health and well-being, not to mention a happy personal relationship.

If you or your partner is experiencing some sort of sexual problem caused by thyroid disease, these tips from the ASHA may help:

  • Talk it through. Communication is key. Be sure you both understand each other’s concerns and needs, and that you’re open to working together to find solutions to any problems that aren’t resolved with treatment.
  • Experiment. For instance, pain during intercourse can sometimes be alleviated by changes in position during intercourse. Sex toys such as vibrators can be especially effective for people who are having trouble becoming aroused or reaching orgasm.
  • See a therapist or counselor. Work with one who specializes in sexuality and sexual problems. The American Association of Sexuality Educators, Counselors and Therapists (AASECT)’s website allows you to search for a sex therapist or counselor in your area.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Krysiak R, Marek B, Okopień B. Sexual function and depressive symptoms in young men with hypothyroidism receiving levothyroxine/liothyronine combination therapy. Endokrynol Pol. 2018;69(1):16-22. doi:10.5603/EP.a2018.0005

  3. Tannenbaum J, Youssef M, Attia AS, Hsieh TC, Raheem O. Hyperthyroidism as an underlying cause of premature ejaculation. Sex Med Rev. 2022;10(1):108-112. doi:10.1016/j.sxmr.2021.03.005

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By Mary Shomon
Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution."