Sudden increases in hair loss Low libido (reduced sex drive) Decreased muscle mass and strength Gynecomastia (male breast enlargement) Erectile dysfunction (inability to get or maintain an erection) Delayed ejaculation (difficulty reaching a climax and ejaculating) Premature ejaculation (climaxing early due to hypersensitivity) Testicular atrophy (shrinking testicles) Loss of fertility (due to low sperm count or quality) Hip and vertebral fractures (commonly older males with hyperthyroidism)
Some are noticeable, particularly if you are under 40 when symptoms like sexual dysfunction are relatively uncommon. Others may be harder to spot, especially with age since may of the symptoms can also affect older males without thyroid disease.
This article describes the symptoms of thyroid disease in males, including those that differ from females and those that are the same. It also explains how to check your thyroid function at home and when it’s time to see a healthcare provider.
General Symptoms of Thyroid Disease
Males are affected by thyroid disease less often than females, but they tend to have similar symptoms. The symptoms are due to changes in the production of thyroid hormones caused by either hypothyroidism (low thyroid function) or hyperthyroidism (overactive thyroid function).
Hypothyroidism
Hashimoto’s disease is the most common cause of hypothyroidism (underactive thyroid) in the United States. This autoimmune disorder results in your immune system attacking and destroying your thyroid and it tends to run in families.
The risk is higher for females and older people. But in the United States, about 3% of males between the ages of 18 and 24 are affected, with hypothyroidism numbers rising to 16% in males who are 74 and older. In Denmark, a comprehensive study put lifetime risk for males at 1.3%.
General symptoms of hypothyroidism include:
Weight gainCoarse, dry skinFatigueFeeling coldConstipationDepressionJoint painMuscle aches or stiffnessMemory problemsHair lossEnlarged thyroid
Hyperthyroidism
Graves’ disease, another autoimmune thyroid condition, is the most common cause of hyperthyroidism (overactive thyroid). When it’s treated, you may eventually experience hypothyroidism.
Graves’ disease is relatively uncommon in men, occurring at a rate of around 1 per 10,000. The rate is nearly eight times higher in women.
Common symptoms of hyperthyroidism include:
Weight loss Feeling nervous or anxious Faster heartbeat Heart palpitations Sweating Tremor Increased appetite Difficulty sleeping Fatigue Muscle weakness Feeling hot Enlarged thyroid
Male Sexual Dysfunction
A 2018 review published in Sexual Medicine Review reported that 59% to 63% of males with hypothyroidism experienced decreased libido, erectile dysfunction, and delayed ejaculation. Among males with hyperthyroidism, 48% to 77% had decreased libido, erectile dysfunction, and premature ejaculation.
When you have thyroid disease, it is not uncommon to have hypogonadism (low testosterone). The abnormal depletion of this male sex hormone can significantly reduce your libido even if you are young and healthy.
Furthermore, in males, hypothyroidism can increase the risk of delayed ejaculation, while hyperthyroidism can increase the risk of premature ejaculation. Both are caused by changes in how nerve sensors in the penis respond to stimulation, either by being understimulated (delayed ejaculation) or hyperstimulated (premature ejaculation).
Diagnosis
Thyroid disease diagnosis is the same no matter your sex. Unfortunately, healthcare providers tend to overlook thyroid symptoms in males since thyroid dysfunction is not nearly as common as it is in women.
Because thyroid disease usually affects males over the age of 40 and many of the symptoms are generalized and vague, healthcare providers will often chalk it up to symptoms of erectile dysfunction, weight problems, and age.
If a healthcare provider suspects that you have a thyroid problem, they will discuss your medical history and symptoms with you, perform a physical exam, and order some blood tests to check your thyroid hormone levels.
Imaging Tests
Imaging tests are commonly used to look for signs of thyroid disease, including goiters and thyroid enlargement (hyperplasia). The tools used can differ, depending on whether you have hyperthyroid or hypothyroid disease.
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If hyperthyroidism is suspected, you may also have imaging tests such as:
Radioactive iodine uptake (RAI-U) test Ultrasound Computed tomography (CT) Magnetic resonance imaging (MRI)
If hypothyroidism is suspected, your healthcare provider may order an ultrasound, but it’s unlikely you’ll need any other imaging tests unless he or she thinks the hypothyroidism is due to a pituitary or brain issue known as central hypothyroidism.
Treatment
Treatment of thyroid disease depends on whether you have hypothyroidism or hyperthyroidism.
Hyperthyroidism
Treating hyperthyroidism usually begins with taking antithyroid medication. Once your thyroid gets back to functioning normally, you may be able to go off of the medication, at least temporarily, or you may need to be on it long-term.
Other treatment options include radioactive iodine ablation, which destroys your thyroid tissue, and a thyroidectomy, a surgery that removes part or all of your thyroid. Both of these treatments eventually result in hypothyroidism.
Hypothyroidism
Having hypothyroidism means that you’ll be taking a thyroid hormone replacement medication, typically Synthroid, Tirosint, or Unithroid (levothyroxine), a synthetic form of T4. This will be a lifelong treatment.
If your symptoms aren’t managed on levothyroxine, your healthcare provider may add Cytomel (liothyronine), a synthetic form of T3. Another option is to take desiccated thyroid extract (DTE), a prescription medication that’s made from pig thyroid and that contains both T3 and T4.
Coping
If you’re having difficulties with sexual dysfunction and you’ve just been diagnosed with thyroid disease, be patient. Treating a thyroid condition drastically improves sexual issues in most people. That said, it can take a while for your thyroid to start functioning normally again.
If you find that you’re still having problems with erectile dysfunction, decreased libido, delayed ejaculation, or premature ejaculation even after you’ve been on treatment for your thyroid, and you’re feeling better otherwise, talk to your healthcare provider about other factors that could be causing your issues.
In the event that you’ve already been diagnosed with a thyroid condition and you’re still having difficulties, sexual or otherwise, it’s possible that your treatment is insufficient. Talk to your healthcare provider about optimizing your treatment so it’s tailored to where your thyroid hormone levels should be for you individually.
Summary
Thyroid disease affects males far less often than females, but many of the symptoms are the same. Men, however, may also experience hair loss, symptoms of sexual dysfunction, and other issues that may depend on whether hypothyroidism or hyperthyroidism are at work.
The key point to remember about thyroid disease in males is that it’s usually, though not always, progressive. Because it can affect multiple organs in your body, it’s important to take note of any and all symptoms you experience.
If you think you have thyroid disease, it’s important to seek a diagnosis from a qualified healthcare provider. If you’re experiencing sexual or erectile dysfunction, be sure to have a thorough thyroid evaluation if only to rule out thyroid disease as a cause.
