Can Hyperthyroidism Cause Sexual Dysfunction in Men?

An often-discussed aspect of men's sexual health is the seemingly eventual, intimate struggle with erectile dysfunction (ED). While numerous factors can contribute to this condition, a lesser-known culprit emerges from the shadows: hyperthyroidism.

Nestled below your Adam's apple lies a small, butterfly-shaped gland that wields an extraordinary influence over our bodies: the thyroid gland. Despite its unassuming size, this organ plays a pivotal role in regulating countless bodily functions, from metabolism and energy levels to growth and development.

However, when the thyroid's delicate balance is disrupted and it shifts into overdrive, a condition known as hyperthyroidism, aka an overactive thyroid, takes hold. Beyond its well-documented effects on metabolism and energy levels, an overactive thyroid gland can silently sabotage sexual dysfunction in men, namely through ED.

In 2008, a study published in the Journal of Clinical Endocrinology and Metabolism shed light on an intriguing correlation between thyroid disorders and men's sexual health. This investigation examined a group of 71 men with thyroid problems. It found that 79 percent of these individuals experienced some degree of ED.

So exactly how does an overactive thyroid cause sexual problems?

Hyperthyroidism and sexual dysfunction in men

Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) have been associated with sexual dysfunction, including ED, in men, said David Shusterman, M.D., a board-certified urological surgeon and the chief physician and founder of New York Urology in New York City.

"Men with hyperthyroidism are more likely to develop ED, while men with hypothyroidism are more likely to have sperm abnormalities, which may affect their fertility," Shusterman explained.

Hyperthyroidism can cause problems with erections, ejaculation and sexual desire, added Michael Werner, M.D., the medical director and founder of Maze Sexual & Reproductive Health, based in New York City and Purchase, New York.

Thyroid hormones play an important role in regulating the body's metabolism, including the production of sex hormones and the function of blood vessels, which are both important to maintaining sexual health, Shusterman said.

"However, the exact mechanisms by which thyroid hormones impact sexual function are not yet fully understood," he added.

Researchers believe ED occurs due to symptoms such as fatigue, depressed mood and low sex drive.

"And when you feel those symptoms, you can have difficulty feeling aroused or getting and maintaining an erection," Werner said.

However, more research is needed to fully understand the mechanisms that link hyperthyroidism and ED.

Hyperthyroidism and premature ejaculation

It's worth noting that research has connected hyperthyroidism to premature ejaculation. The definition of premature ejaculation, according to the International Society for Sexual Medicine, consists of a couple of components:

• Ejaculation that always or nearly always occurs before or within about one minute of penetration from the first sexual experience (lifelong premature ejaculation), or a clinically significant reduction in latency time, often to about three minutes or less (acquired premature ejaculation)
• The inability to delay ejaculation on all or nearly all penetrations and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy

A 2009 study published in the Journal of Urology included 43 male patients with hyperthyroidism. Thirty-one of the 43 patients (72.1 percent) suffered from premature ejaculation.

Similar to hyperthyroidism and ED, little is understood about the connection between hyperthyroidism and premature ejaculation. However, further studies have identified that managing hyperthyroidism can alleviate the symptoms of premature ejaculation.

Hyperthyroidism and fertility

Hyperthyroidism may cause fertility problems in men. Thyroid hormone levels that are imbalanced, whether in excess or deficit, can impact the functioning of the testes and, subsequently, affect semen quality.

Specifically, hyperthyroidism is linked to the following symptoms:

• Decreased semen volume
• Reduced sperm density and motility (movement)
• Altered sperm morphology (shape)

This relationship between hyperthyroidism and reproductive health highlights the importance of assessing thyroid function in the diagnostic workup of a man experiencing infertility. If you have a thyroid problem and are having difficulty conceiving, mention it to your healthcare provider.

Can you avoid hyperthyroidism?

Hyperthyroidism in men can occur due to various underlying causes, with some of the primary factors including the following:

• Graves disease. This autoimmune disorder is the most common cause of hyperthyroidism in men and women. Graves disease causes the body's immune system to mistakenly attack the thyroid gland, which produces excessive thyroid hormone production.
• Toxic multinodular goiter. This condition involves the development of multiple nodules or lumps within the thyroid gland. These nodules become overactive and produce excessive amounts of thyroid hormones.
• Thyroiditis. Inflammation of the thyroid gland, aka thyroiditis, can cause temporary hyperthyroidism. Various factors can trigger this condition, including viral or bacterial infections, autoimmune disorders or certain medications.
• Excessive iodine intake. Consuming excessive amounts of iodine, either through dietary sources or certain medications can cause an overactive thyroid. (This is very rare and usually only occurs if there is already a problem with the thyroid.)
• Thyroid nodules. Occasionally, solitary nodules within the thyroid gland called toxic adenomas can cause excessive thyroid hormones.

"There is no sure way to prevent hyperthyroidism, but some risk factors can be reduced, such as not smoking and avoiding exposure to radiation," said James J. Elist, M.D., a urologist in Beverly Hills, California, who specializes in impotence and male sexual dysfunction.

How is hyperthyroidism treated?

A healthcare provider can treat hyperthyroidism with medications, radioactive iodine therapy or surgery, according to Shusterman. Treatment choice depends on the patient's age, overall health and the severity of the condition.

"Antithyroid medications, such as methimazole or propylthiouracil, are often the first-line treatment," he said. "But radioactive iodine therapy is a common choice for patients who do not respond well to medication or have recurrent hyperthyroidism."

Surgery may be necessary in cases of large goiters or if the patient cannot tolerate other treatments.

Treating hyperthyroidism and managing sexual dysfunction can be tricky, however. Elist said some medications used to treat hyperthyroidism, such as beta blockers, can cause ED or other sexual side effects.

"It is important to discuss any concerns about sexual function with a healthcare provider, who can recommend appropriate treatments or adjustments to medication," he said.

Fortunately, telehealth makes it easy to connect with a provider who can answer your questions and evaluate your situation, often through video visits. Many of them offer same-day appointments.