Sexual Dysfunction and Thyroid Disease

Show Article Table of Contents

The hormones produced by the thyroid gland influence virtually every cell, organ, and system in the body, including those that involve sexual health and pleasure. It should come as no surprise, then, that thyroid disorders often are associated with sexual dysfunction issues. Both hypothyroidism and hyperthyroidism have been linked to erectile dysfunction (ED) for men, painful intercourse for women, and low libido for both genders, among other problems.

Often sexual issues caused by thyroid disease 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. Couples can also benefit from using helpful coping strategies when one partner's thyroid condition is impacting intimacy.

Thyroid Disease and Sexual Health

It's estimated that as many as 43 percent of women and 31 percent of men experience some type of sexual dysfunction, according to the Cleveland Clinic.

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 in each sex as well.

These are the issues most often associated with thyroid disorders; note, however, that little is known about how what portion of sexual problems experienced by people overall might involve a thyroid disorder.

Women with thyroid disease may experience:

  • Loss of sex drive: According to the American College of Obstetricians and Gynecologists (ACOG), diminished libido often is a complication 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 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.

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. A 2008 study found that in 71 men with thyroid problems, 79 percent had some degree of erectile dysfunction.
  • Ejaculation issues: According to the Sexual Medicine Society of North America (SMSNA), men who have a 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 hypo and hyperthyroidism may have this side effect in men.

Diagnosis

If you're experiencing some type of sexual dysfunction, your doctor may want to do a thyroid evaluation, including a blood test to measure your levels of thyroid hormone.

In fact, this was recommended by the authors of a 2018 study looking at ED and subclinical hypothyroidism (meaning the levels of thyroid hormone are low but not causing symptoms) which found that a significant number of men with erectile dysfunction also had the thyroid condition.

Treatment

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

  • Thyroid medication: The standard drug prescribed for hypothyroidism is levothyroxine, a synthetic form of the T4 thyroid hormone thyroxine sold under the brand names Synthroid, Levothroid, Tirosint, and others. In studies, men with sexual dysfunction problems who also had hypothyroidism experienced improvement in their sexual symptoms after taking the drug. In addition, sometimes a person who already is taking thyroid medication may have improvements in sexual function after their treatment is tweaked.
  • Phosphodiesterase-5 (PD-5) inhibitors: These medications, which include Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil), are effective for treating erectile dysfunction and do not interact with thyroid treatments.
  • Osphena (ospemifene): This is a hormonal treatment for postmenopausal women that targets changes in the vagina that can cause dryness and painful intercourse. It's safe for women with thyroid disease to take, but 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 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.
    Was this page helpful?
    Article Sources