Sexual Dysfunction and Thyroid Disease Solutions

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According to study published in the Journal of the American Medical Association (JAMA), about 43 percent of women and 31 percent of men suffer sexual dysfunction. Interestingly, these figures are thought to be low, underestimating the extent of real sexual dysfunction in the U.S. In this article, you'll learn more about how sexual dysfunction is defined, diagnosed, and treated, as well as specific guidance about the connection between sexual dysfunction and thyroid disease.

The Types of Sexual Dysfunction

There are generally four different types of sexual dysfunction:

  • Lack of desire or interest in sex
  • Inability to become aroused
  • Inability to climax, or very slow to climax
  • Pain during intercourse

The Signs and Symptoms of Sexual Dysfunction

The signs and symptoms for men including inability obtaining an erection, or difficulty maintaining an erection - known as erectile dysfunction, or ED - and an inability to ejaculate, or inability to control the timing (premature ejaculation, or delayed ejaculation). In women, there may be inadequate lubrication, an inability to relax the vaginal muscles, or an inability to have an orgasm. Both men and women can experience a lack of interest in sex, an inability to become aroused, or pain during intercourse.

Causes of Sexual Dysfunction

There are a number of possible causes of sexual dysfunction, including:

  • Thyroid dysfunction
  • Other hormone imbalances

It's estimated that these physical factors are a cause of sexual dysfunction in at least a third of the men who have concerns, and more than 10 percent of women with sexual dysfunction issues.

The remainder of people experiencing sexual dysfunction are thought to have issues that are psychological in origin -- including stress, anxiety, concerns about sexual performance, relationship issues, guilt, depression, body image issues, and a history of sexual trauma.

The Sexual Dysfunction Medical Workup

For someone who has not been diagnosed with thyroid disease, but is experiencing sexual dysfunction, a complete thyroid evaluation -- including TSH, Free T4, Free T3, and thyroid antibodies -- should be part of the medical workup.

For someone with thyroid disease that has already been diagnosed, a key first step in addressing sexual dysfunction is to ensure that thyroid treatment is not just being received, but that the treatment is optimized. To understand what optimal treatment means, a good starting point is this article on How to Interpret Your Thyroid Test Results.

Other elements of a medical workup for sexual dysfunction typically include:

  • A complete medical history
  • A thorough physical
  • Evaluation of other hormones besides thyroid, including testosterone for both men and women
  • Review of medications and supplements being taken
  • A discussion with the practitioner about possible psychological factors, such as stress, relationship problems, fear, and sexual trauma

Treatments for Sexual Dysfunction

In some cases, men can benefit from drugs such as sildenafil (i.e., Viagra), tadalafil (i.e., Cialis), and vardenafil (i.e., Levitra), which increase blood flow to the penis. Some men and women who have low testosterone levels benefit from testosterone supplementation. In women who are perimenopausal, or who have had a surgical menopause, hormone treatment involving estrogen and/or progesterone may be helpful as well.

Some men also benefit from vacuum devices and implants that can help with erectile dysfunction. For women who have pain due to a narrow vagina or tight muscles - vaginismus - dilators may be an effective part of treatment.

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. And, medically, being overweight can reduce sex drive. Specifically, losing weight also 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 improves blood flow to all 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, 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 the psychological issues involved

Sexual Dysfunction and the Thyroid

How many people with sexual dysfunction may actually have underlying thyroid disease that has not been diagnosed? It's not a question that has been thoroughly researched, but it's certain that some of the people having a problem could solve their sexual dysfunction problem in the first place by having their thyroid function evaluated and properly treated.

Still, many people -- women in particular -- continue to experience sexual dysfunction even after their doctors consider the thyroid problem "treated." Here are some specific steps for thyroid patients:

1. Optimized Treatment

Make sure your thyroid drug treatment is optimized. It may not be enough for your levels to be "normal." You may find that sexual dysfunction is resolved when treatment is considered optimal.

Some people do not find their symptoms -- including sexual dysfunction -- resolved when taking a levothyroxine/T4 only drug like Synthroid. Some people find that their sexual dysfunction is resolved or improved when their doctors add in a synthetic form of the T3 hormone - i.e., Cytomel -- or switch them to a natural thyroid drug like Armour or Nature-throid, that includes natural forms of T4 and T3.

2. Address Hormonal Imbalances

Other endocrine and hormone imbalances are more common in thyroid patients. Be sure to have your sex hormones (estrogen, progesterone, and testosterone in women, and testosterone in men) checked. For men who have thyroid issues, testosterone may be insufficient, and supplementation can be an aid in restoring lost libido. Testosterone is available as a pill form, as a transdermal patch, by injection, and sometimes as transdermal pellets implanted under the skin. Some women can also benefit from testosterone. Doctors frequently will provide testosterone in pill form to women, or as testosterone propionate cream.

It's also important to have adrenal function evaluated, specifically, cortisol and DHEA, and any imbalances evaluated.

3. Consider Supplements

There are a number of supplements that can help with sex drive. Be sure to check with your practitioner for guidance on how safely use these supplements.

  • Arginine - An amino acid, for both men and women
  • Asian Ginseng (Panax) - Asian ginseng -- also called panax -- may help increase sexual energy
  • Avena-Sativa/Oat Extract - This supplement (main brand is Vigorex), reportedly helps with sex drive
  • DHEA (dehydroepiandrosterone) - DHEA is a precursor hormone that converts to testosterone by your body, may be useful to both women and men
  • Ginkgo Biloba - Ginkgo biloba is an herb that may improve sexual function in men
  • Horny Goat Weed - Used by Chinese herbalists, it may help improve sexual functions in both men and women
  • Kava Kava - Kava kava is an herb most known for use in relaxation but may be useful as an aphrodisiac for women
  • Zinc - Low levels of zinc have been associated with low sex drive in women and men
  • Royal Maca - Maca is a South American herbal remedy that may help women with libido

Dr. Cathy Wong,'s Alternative Medicine expert, guide, also has several excellent resources on supplements for sexual health, including:

Note: Always check with your practitioner about herbs and supplements.


Laumann E, et. al. "Sexual dysfunction in the United States: prevalence and predictors." JAMA. 1999 Feb 10;281(6):537-44.

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