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Hypothyroidism and Erectile Dysfunction

Learn how to identify if your underactive thyroid may be causing erectile dysfunction and what to do.
Hypothyroidism and Erectile Dysfunction
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In this article:

  • Defining erectile dysfunction (ED)
  • How thyroid hormones influence the male sexual response
  • Treating hypothyroidism to solve erectile dysfunction

Erectile dysfunction (ED) can be a significant problem for men and their partners. Sure, when TV commercials advertise ED medications, it seems easy to laugh. Yet, when it's you or your partner, it is no laughing matter. ED can affect your self-image, self-confidence, your overall feeling of well-being, and relationships. When people rack their brains for answers behind their particular case of ED, it is easy to skip over endocrine disorders. However, too much or too little thyroid hormone may be just the thing that's killing your intimacy.

 Defining erectile dysfunction (ED)

Erectile dysfunction is when a male has difficulty getting or maintaining an erection that is firm enough for intercourse. It is the most commonly experienced sex problem in men and affects more than 30 million men. It is normal to experience difficulty getting an erection now and then. However, if it starts becoming more frequent or worsens, it is not normal and requires further investigation with your doctor. Additionally, ED tends to become more prevalent as men get older.

Sexual arousal is a highly complex process that involves your brain, emotions, hormones, peripheral nervous system, muscles, and blood vessels. Several things can interfere with the male sexual response, including:

  • Emotions, stress, depression, or anxiety
  • Decreased blood flow or damaged nerves in the penis
  • Alcoholism and tobacco use
  • Prostate enlargement or cancer
  • Low testosterone and other hormonal imbalances
  • Spinal cord injuries
  • Diabetes and metabolic syndrome
  • Cardiovascular disease (high blood pressure, high cholesterol, etc.)
  • Obesity
  • Sleep disorders

Sometimes, the cause of ED is straightforward. However, defining the cause of your ED typically requires a process of elimination.


How thyroid hormones influence the male sexual response

The thyroid, an endocrine gland, is likely not the first thing that comes to mind when it comes to ED. Yet, some research indicates that endocrine disorders, such as low testosterone, diabetes, hypogonadism, and thyroid dysfunction, could be behind 2-23% of all cases. 

Hypothyroidism is one of the most common endocrine disorders in both men and women. In this condition, the thyroid makes too little thyroid hormone to support the body's metabolic needs. Literature reviews suggest that low thyroid hormone contributes to 6% of all ED cases. One study finds that 79% of men with thyroid problems have some degree of ED, and most cases were in men with hypothyroidism compared to hyperthyroidism.

Several symptoms of hypothyroidism may interfere with sexual response, including:

  • Hypertension
  • Depression

Understandably, many of these symptoms can impact sexual desire and the ability to achieve and maintain an erection. Yet, experts are still not sure of the mechanical relationship between thyroid hormones and sexual response. 

Treat hypothyroidism to solve erectile dysfunction

If you’re worried about your inability to get or keep an erection, you can take a thyroid blood test to understand how your thyroid is functioning. Many labs only look at thyroid-stimulating hormone (TSH). Still, it’s critical to also measure free triiodothyronine (fT3), free thyroxine (fT4), and TPO antibodies. These four markers help you understand the big picture of what’s happening with your thyroid function, and where specifically to make improvements. 

Should your results show that your thyroid is underactive, it is treatable in almost everyone. Optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms like erectile dysfunction, low libido, or depression. When choosing thyroid medication with your doctor, remember that there is no one-size-fits-all treatment. 

Work with a trustworthy thyroid doctor who can assess your symptoms, history, and lab results to determine the best treatment plan for you.

A note from Paloma Health

Even though thyroid medication may be an effective solution for ED in men with hypothyroidism, many other factors may be causing your ED. Thus, it is essential to see your doctor and bring a complete list of your medications, medical history, and family history. The more information you can give your doctor, the better your chance is to discover the root cause of your erectile dysfunction. 


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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