Sunday, June 20, 2010

Female Sexual Dysfunction and Hypothyroidism

The thyroid gland’s importance in the body is essentially related to its regulation of many aspects of the body’s functions. Dysfunction of the thyroid, either overactive or underactive, is a common problem experienced by many women. Low thyroid, or hypothyroidism, can occur after removing the thyroid, simply low functioning of the thyroid, or autoimmune diseases such as Hashimoto’s thyroiditis.

Low thyroid function can affect mood, metabolism, weight, heart rate, brain function, hair, and ovulation. It is therefore a stretch to hypothesize if hypothyroidism affects sexuality? In other words, is hypothyroidism linked to female sexual dysfunction (FSD)?

TSH (Thyroid stimulating hormone) is the common blood test used to screening for hypothyroidism. When TSH levels are abnormally high, this suggests low circulating thyroid hormone from an underactive thyroid. TSH production from the pituitary gland will increase to try to “rev up” the sluggish thyroid gland if it’s underactive in order to push it to produce more thyroid hormone. Usually, TSH above 5 is considered “high/abnormal”, but it’s important to note that if the patient “feels normal” and has a slightly elevated TSH, then thyroid hormone replacement may not necessarily be warranted. Conversely, if the TSH is within the “normal range” (less than 5), but the patient appears sluggish or "clinically hypothyroid", then thyroid hormone replacment may be warranted. This goes to the point of "treating the patient, no the number".

A study was recently published looking at four groups of women, comparing their thyroid status, to see if it links to female sexual dysfunction. The four groups were:

Women who were clinically hypothyroid

Women with a TSH less than 10, but overtly hypothyroid

Women with a TSH greater than 10 but not overtly hypothyroid

Control group of women with "normal thyroid"

FSD was diagnosed in 56% of women who were clinically hypothyroid, and 54.6% of women with a TSH greater than 10. By contrast, the control group of women, and the group of women with a TSH less than 10 reported 15% and 14.6% FSD, respectively. In addition, prolactin levels were also found to be higher in the clinically hypothyroid group, as well as the group with a TSH greater than 10, but no so in the other two groups of women. Other hormone levels, such as estradiol, free testosterone, FSH, and LH were all normal across the board.

As a sidebar, Prolactin is a pituitary hormone that is linked to lower sexual function as well. Lactating women post-pregnancy will have elevated prolactin levels, a “protective mechanism” to allow nurturing of the infant and avoidance of early sexual interest that may be a distraction during this time.

The importance of this study, which was quite simple and straightforward in design and results, should help us remember to screen for female sexual dysfunction in women with hypothyroidism. It may be simply overlooked when busy physicians are concerned with fixing one problem, to not neglect secondary conditions which may co-exist.


Anonymous said...

Thank you for this post. It has been 5 years since I was treated at 20 for thyroid cancer and removing my thyroid, I am just now starting to get information on this topic. I thought it was all in my head but all the lack of desire began around that time. One question I do have though, I am on thyroid replacement now and even though I am in "normal range" could I still have FSD? Thank you so much for your help.

susie said...

I'm in an almost identical situation. I'm on the very far end of normal range, after having been extremely hyperthyroid, before my surgery, for most of my life. My sex drive and ability to orgasm is stagnating. I'm curious if this is because of a deficiency of hormone or because of the comparison to the way my life was before.

Claudia said...

I read through the thyroid supplement and it seems very good. A different approach using thyroxine-free thyroid glandular extracts, which provide the thyroid with peptides and cofactors that are found in the gland itself and are required as part of normal thyroid function.

kamagra 100mg said...

Studies suggest that as many as half of American women suffer from some type of sexual dysfunction, with lack of interest in sex at the top of the list. Although depression and other psychological issues are major contributors to low libido in women, illness also plays a major role.

Anonymous said...

What is the source of the study you quoted. I would like to read it please. Thanks.

Matthew E. Karlovsky, M.D. said...

The study citation:

J Sex Med. 2010 Jul;7(7):2583-90