In the years since I was diagnosed with hypothyroidism, each day seems to bring about a new and unexpected symptom. But putting the pieces together and discovering that my hypothyroidism was negatively affecting my sex life felt like a gut-punch, even more so than finding out about the gastrointestinal problems or night sweats. This aspect of my life that had come to feel so wholly and totally mine was just another thing to add to the list of things stolen by this illness.
The thyroid is a butterfly-shaped gland located at the base of the throat. It controls the speed at which every cell of the body operates — a process known as metabolism. When the thyroid is off, it isn’t able to properly produce T3, T4, and TSH (Thyroid Stimulating Hormone) — which are the hormones that communicate to the body how each bodily process should go. This can affect literally everything from digestion to brain function to fertility.
Before having a thyroidectomy, I didn’t even know what the thyroid was. I was completely unprepared for how it would affect my life, but even more how it would affect my sexual health ± as doctors aren’t always so keen on talking about these things with patients. When I was being prepared for life post-thyroid, not once did any of my doctors mention how it would affect my menstrual or sexual health. And, as it turns out, thyroid disease has totally changed my sex life.
Thyroid disease can affect everything from sexual arousal to fertility
“Hormonal disorders — including an under-active thyroid — are responsible for about one third of all sexual problems people experience,” says Dr. Vedrana Högqvist Tabor, PHD, CEO of Boost Thyroid. Low T4 (one of two thyroid produced hormones) or high TSH (thyroid stimulating hormone) are to blame.
The imbalance of these hormones can cause hyperprolactinemia, or elevated levels of prolactin in the blood. Prolactin is made by the pituitary gland and affects the level of estrogen and testosterone in people. When T4 and TSH are out of whack, it can also cause the sex hormone binding globulin (SHBG) levels to change, which can throw off the estrogen, testosterone and progesterone balance. Low thyroid hormone levels can cause changes in blood vessels and nerve sensitivity, resulting in reduced sex drive, breast pain, painful vaginal penetration, and vaginal dryness.
“Sexual disorders are typically experienced more by people who have fatigue, muscle pain, and/or feel depressed,” says Dr. Högqvist Tabor. “These are all common side-effects of a thyroid condition, so tracking can help patients understand when these symptoms worsen and improve.”
Thyroid disease can cause a variety of symptoms that affect a person’s sex life from low sex drive, difficulty getting aroused, erectile dysfunction, vaginal dryness, inability or difficult reaching orgasm, delayed ejaculation and pain during or after vaginal intercourse.
Why aren’t more people talking about this side effect?
“Awareness depends on three factors: the patient, the physician, and the country,” says Dr. Högqvist Tabor. “It depends whether the patient will share any sexual problems with their physician, whether the physician is aware of the thyroid and sex connection and their country’s guidelines for physicians.”
Sexual health is a major part of a person’s health, and why these sexual side-effects have been continuously ignored or glossed over by my doctors when hypothyroidism affects approximately 10 million Americans (and as many as 10 percent of women experience some thyroid hormone deficiency) still sort of baffles me. If I had known what to look for, I may have been clued-in earlier when I first had a dip in my hormone levels or when my birth control was interacting weirdly with my thyroid meds. Being sexually well is part of being totally well and ignoring that doesn’t do anything but hurt patients.
A version of this story was published January 2020.
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