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Written by Paloma Health
Medically reviewed by Dr. Yasmin Akhunji, MD
An underactive thyroid can lead to sexual changes that can be frustrating for both you and your partner or partners.
Hypothyroidism is a condition in which your thyroid hormone production drops when your thyroid is underactive. Part of the endocrine system, the thyroid is a butterfly-shaped gland at the base of your neck responsible for making and storing hormones. These hormones help to regulate the body's energy use, along with many other essential functions.
When your thyroid hormone production drops, virtually every process in the body slows down and changes, too. These changes may result in sexually disruptive symptoms like vaginal dryness, depression, fatigue, or weight gain.
Other common symptoms of hypothyroidism include:
- Dry, flaky, or scaly skin
- Hair loss or thinning
- Increased sensitivity to cold
- Muscle aches, tenderness, or stiffness
- Irregular menstrual periods
- Slow heart rate
- High blood pressure
- Enlarged thyroid gland (goiter)
Dr. Yasmin Akhunji, an Arizona-based endocrinologist with Paloma Health, says, “According to the Cleveland Clinic, it is estimated that as many as forty-three percent of women and thirty-one percent of men experience some type of sexual dysfunction. 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 on each sex as well. While women can experience loss of sex drive, hypoactive sexual desire disorder (HSDD), and painful sex, men can experience erectile dysfunction, ejaculation issues, and a decline in their libido.”
Many hormones are part of a regulatory feedback loop. When thyroid hormone production drops, it disrupts this loop. Thyroid hormone triiodothyronine (T3) increases the sensitivity of the luteinizing hormone (LH), which controls the production of sex hormones by the ovaries. So, when thyroid hormone production drops, LH may also remain low, possibly resulting in lower desire.
Low desire, difficulty with arousal or orgasm, pain as part of sex, or simply just not feeling in the mood may result in feelings of distance and rejection on all sides.
Of course, you're reading this article because you want more intimacy and connection, but are unsure how to move forward. Ahead, a few tips for how to reconnect and be more intimate.
1. Test and treat your thyroid
Start by fully understanding your thyroid function. We believe it's critical to measure thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and TPO antibodies to understand the big picture of what's happening with your thyroid function, and where specifically to make improvements.
“I encourage anyone experiencing some type of sexual dysfunction to talk with their doctor about the possibility of checking for thyroid dysfunction,” says Dr. Akhunji.
An underactive thyroid is easily treatable in almost everyone. Taking thyroid hormone replacement medication to optimize your thyroid levels is usually the first step in minimizing symptoms like low libido. Remember that there is no one-size-fits-all treatment when choosing thyroid medication with your doctor.
2. Talk to your partner
An open conversation about your sexual relationship can move your relationship forward. We know that this isn't always easy or comfortable, but bringing to light your needs and limitations can help both partners work together. Try, "Hey, we aren't intimate with each other as much anymore. I feel restricted and frustrated because of my thyroid, but I miss the physical closeness, and wonder how you feel about it?"
Being heard and understood is essential to rekindling desire. This responsiveness supports your intimate and sexual connection by showing your partner that you have care and concern for their well-being, too.
3. Be patient with your body
How you feel and perceive yourself can affect your health and what's happening with your libido. Symptoms like weight gain and hair loss might make you feel uncomfortable in your body.
Practice patience. Stand naked in front of the mirror and notice things that you accept, like, or love about your changing body. Usually, we're quick to feel frustration with the things we dislike, but getting comfortable in your skin may help you feel in the mood more often.
Additionally, learn to be patient with yourself when your body doesn't respond the way you want, sexually. Living with hypothyroidism may be a new experience for both you and your partner. You may need to learn new ways to be intimate together and take things more slowly than in the past.
4. Get creative in the bedroom
During sex, experiment with pillows or other supports to take the pressure off painful joints. Think back to that thing about communication. Keep talking and experimenting with one another until you find something that works — no need to take this too seriously. If something feels painful or awkward, or simply like too much energy, try something else! Aaliyah said it best, "If at first you don't succeed, dust yourself off, and try again."
5. Focus on the sensual over the sexual
If sex is uncomfortable, experiment with different foreplay or touching instead. Intimate touch doesn't even need to be sexual, but it can stir up new sensations and help you connect as a couple.
Spend time exploring each other's bodies without any expectation of sex. Try hugging for one whole minute, holding hands, slow dancing, cuddling, playing with each other's hair, softly touching each other's body, or exchanging gentle massage.
6. Get more sleep
We know that this doesn't sound that sexy. Still, the stress of work, family, life on top of any fatigue you might experience as a symptom definitely isn't increasing desire. Too much stress can throw your endocrine system out of balance, so it's important to get rest and find relaxation to set the mood. In the long run, feeling relaxed and well-rested leads to a better experience for both partners.
In addition to sleep, to get into the mood, you might try a warm bath or shower to soothe achy joints or turn up the thermostat to ease your cold sensitivity.
7. Practice makes progress
We don't even necessarily mean sex - though that's good, too. Practicing intimacy takes time and attention. When there are long stretches between the expression of affection, you may feel awkward or weird trying to get back into the habit.
Work at it and make modifications with your partner as needed. Maybe a specific time of day isn't working for you, or you want to try a different position that's easier on your joints. Define intimacy for yourself and keep practicing!
We know that you want and deserve a relationship in which you feel alive, inspired, and not limited by your thyroid condition. Beyond taking thyroid hormone replacement medication, you can support your thyroid with nutrition and lifestyle modifications, as listed above, to rekindle your desire.