Man sitting on bed touching his thyroid with a text bubble

If You Have ED, Your Thyroid May Be Sending You Signals

An overactive and underactive thyroid can lead to serious health issues—as well as problems downstairs.

Maybe you’ve just started experiencing some sputtering when it comes to your libido. Or there could be an issue with erectile dysfunction. Either way, you probably think about sex a lot these days—but what about your thyroid? The gland has been linked to sex drive (for both men and women) and ED, so if there are problems with your thyroid that could be cause for sexual dysfunction—and low desire.

Although there can be numerous causes for ED and low libido—from work stress to use of blood pressure medications (1)—one common culprit is your thyroid, says Yoshua Quinones, M.D.

“Thyroid abnormalities, such as hypothyroidism and hyperthyroidism, disrupt hormonal balance,” he says. These imbalances can lead to fatigue, changes in mood, and altered blood flow. Those all contribute to decreased libido and sexual dysfunction.”

Let’s take a deeper look at the connections between thyroid, libido and ED, along with strategies that may help quiet the alarm your thyroid has been setting off.

About the Experts:

Yoshua Quinones, M.D., an internist with Medical Offices of Manhattan in New York. He specializes in internal medicine, hormonal health, hypertension, diabetes, obesity, mental health, and overall well-being.

Natalie Kunsman, M.D., an integrated health advisor and physician at Broad Health, Hone Health’s partnered medical practice. She specializes in family medicine as well as anti-aging and regenerative medicine in Colorado Springs, CO. She also has expertise in thyroid and hormonal health.

How Does a Thyroid Problem Affect Your Sex Life?

Think of your thyroid gland as a master symphony conductor, with endocrine glands as the orchestra members, says Natalie Kunsman, M.D.

The thyroid conducts the pace of the music. In your body, that means regulating the degree to which other hormones are released, including cortisol and prolactin. Cortisol is known as the stress hormone, but it’s also necessary for giving you energy and prompting sexual arousal (2). Whereas the hormone prolactin helps regulate testicular function as well as testosterone and sperm production (3).

When your thyroid pumps out too much thyroid hormone (called hyperthyroidism), it can lead to a range of difficulties, such as muscle weakness, trouble sleeping, diarrhea, mood swings, and unexpected weight loss (4).

If your thyroid doesn’t crank out enough thyroid hormone (hypothyroidism) you might feel fatigued, gain weight, or notice joint and muscle pain, or depression (5).

Thyroid and Low Libido

Thyroid dysfunction can be a significant factor in low libido because of the role it plays in testosterone regulation—the primary male sex hormone. Libido is your sex drive, so when you have low libido, it means you have a decrease in sexual desire.

The impact of thyroid dysfunction on hormone regulation affects women as well, and can show up as low desire, lack of lubrication, difficulty with orgasm, and even pain during intercourse (6).

Libido varies greatly from one person to another. It’s also natural for sex drive to fluctuate (7). For example, fatigue or anxiety can temporarily zap your interest in sex.

Libido also tends to decrease as you age—but if you persistently have low libido (meaning longer than a couple months) or experience a sudden drop in sex drive, you should consider getting checked out by a doctor, Quinones says.

Decline in sex drive

A research review found in a 2018 issue of Sexual Medicine Reviews found that there’s an increased prevalence of sexual dysfunction among people with thyroid disorders (6).

Libido requires a complex interplay of brain chemicals, hormone levels, metabolism, blood flow, and temperature regulation, says Kunsman.

“We’ve seen that thyroid impacts all of these, so if your sex drive is going down without any explanation, you may want to start with basic blood work that looks at thyroid [hormone] in addition to testosterone,” she says.

Thyroid and ED

Whether your sex drive is affected or not, you could also be experiencing erectile issues if your thyroid is a factor, because testosterone plays a role for those, too.

Delayed/premature ejaculation

If the thyroid is hyperstimulated, as would be the case with hyperthyroidism, you may feel more sensitivity during sex, which can lead to premature ejaculation, Kunsman says.

One 2009 study that looked at the connection between excess thyroid hormone and premature ejaculation, found that treating people for thyroid regulation significantly improved their ejaculation time frame (8).

“The opposite is also true, where a sluggish thyroid may lead to delayed ejaculation or difficulty with climax,” Kunsman says.

Thyroid and Sperm Count

Not only do thyroid hormones play a role in libido and sexual function, they can also affect sperm in significant ways, according to a 2018 study (9). Having too much or too little thyroid hormone can result in semen abnormalities, the researchers noted.

Specifically, hyperthyroidism has been associated with reduced sperm volume while hypothyroidism is linked to changes in the size and shape of sperm. Either of these situations can contribute to male infertility.

Treatments for Thyroid Problems

The usual treatments for a wonky thyroid include medications. Levothyroxine is often prescribed to balance hormones for underactive thyroid, while antithyroid drugs like methimazole are helpful for overactive thyroid, Quinones says.

“In certain circumstances, we may recommend either removing the thyroid or using radioactive iodine to address specific thyroid issues,” he adds. However, this option tends to be reserved for if medication fails.

Because thyroid problems can worsen if they go untreated, it’s crucial to treat the thyroid rather than let an imbalance drag on for months or even years, he notes.

How to Regain Your Sex Drive

Getting your thyroid levels checked (as well as your testosterone levels), can be a first step toward pinpointing the cause of ED and low libido.

Along with that strategy, Kunsman suggests evaluating lifestyle factors such as focusing on your sleep quality, shifting to a healthier diet, and getting regular physical activity, since all play a part in your sex drive.

“If there are some psychological factors impacting this, talk to a therapist and your partner,” she says. “For changing your mindset you can also spice it up by changing scenarios, environment, and timing to ignite the passion all over again.”

The bottom line? A combination of healthy lifestyle changes and keeping your thyroid health in check may help you boost your libido, and in part, decrease bouts of ED.

Hone’s test, which you can take from the privacy of your home, can analyze your testosterone levels.