Published November 24 2014
Although most of the people with thyroid and autoimmune thyroid conditions are women, there are men who have these conditions as well. And it’s not uncommon for men with thyroid imbalances to have erectile dysfunction. Sometimes the erectile dysfunction is unrelated to the thyroid condition. On the other hand, many times the thyroid imbalance is causing erectile dysfunction.
Most cases of erectile dysfunction affect men older than 40 years (1), although I’ve worked with some younger adult men with this problem. Worldwide, approximately 140 million men have erectile dysfunction, and the number is expected to double over the next 15 years (2). I’ll discuss the relationship between erectile dysfunction and thyroid health later in this article, but some of the other causes of erectile dysfunction include the following:
- Diabetes
- High blood pressure
- Depression
- Multiple sclerosis
- Parkinson’s disease
- Certain medications (i.e. beta blockers)
- Nerve damage
- Stress and anxiety
- Low testosterone levels
Although physical causes account for most cases of erectile dysfunction, there frequently is a psychogenic component as well (3). Atherosclerosis is estimated to account for 40% of erectile dysfunction in men over 50 years, and erectile dysfunction may be considered an early marker for cardiovascular disease (3). A meta-analysis of twelve cohort studies involving 36,744 participants suggested that erectile dysfunction significantly increases the risk of cardiovascular disease, coronary heart disease, stroke, and all-cause mortality (4).
This makes sense when you look at the physiology of a penile erection. In a healthy male, sexual stimulation causes the dilatation of the arterioles and arteries by increased blood flow (5). In addition, the penis is innervated by both the sympathetic and parasympathetic system, as well as the sensory and motor pathways (5). As a result, any factor which interferes with the blood flow or nerve innervation of the penis can lead to erectile dysfunction.
The Relationship Between Erectile Dysfunction and Thyroid Health
Numerous studies show a relationship between thyroid conditions and erectile dysfunction, and it appears that both hypothyroidism and hyperthyroidism can increase the prevalence of erectile dysfunction. One study involving seventy one men, 27 with hyperthyroidism and 44 with hypothyroidism, found that erectile dysfunction is extremely common with both types of thyroid conditions, and balancing the thyroid hormone levels usually helps to restore erectile function (6). Another study looked to evaluate the effect of hypothyroidism on erectile function and concluded that hypothyroidism adversely affects erectile function, along with sperm count and motility (7). A case-control study looked at the relationship between erectile dysfunction and hyperthyroidism, and confirmed an association between erectile dysfunction and prior hyperthyroidism (8). Another study investigated the association between thyroid health and erectile function in two different cohorts of subjects, and found that overt hyperthyroidism was associated with an increased risk of severe erectile dysfunction (9). The same study found no association between primary hypothyroidism and erectile dysfunction.
So it does seem that both an underactive thyroid and an overactive thyroid can cause erectile dysfunction. However, according to these studies erectile dysfunction seems to be more common in hyperthyroid conditions. Either way, the obvious goal should be to balance the thyroid hormone levels, and if this hormone imbalance is what caused the erectile dysfunction then addressing the thyroid condition should help with this.
Erectile Dysfunction: Conventional and Natural Treatment Methods
As for conventional treatment methods for erectile dysfunction, if it’s not an ongoing problem then no treatment is usually administered. On the other hand, if this becomes a frequent problem then treatment will most likely be recommended. Sometimes lifestyle changes are recommended by medical doctors, and this almost always should be the first step. Obviously if a medication the person is taking is suspected to be a potential cause of erectile dysfunction then this should be addressed. Phosphodiesterase-5 (PDE5) inhibitors such as Viagra, Levitra, and Cialis are commonly recommended. Besides not doing anything to address the cause of the erectile dysfunction, there is also the possibility of side effects when taking these medications.
As for correcting erectile dysfunction through natural treatment methods, in most cases one or more of the following approaches will help to resolve the problem:
1. Balance the thyroid hormone levels. As I mentioned earlier, a thyroid hormone imbalance can cause erectile dysfunction. This is true with both hypothyroidism and Hashimoto’s Thyroiditis, as well as with hyperthyroidism and Graves’ Disease. If the thyroid imbalance is responsible for the erectile dysfunction, then obviously correcting this imbalance should help.
2. Correct other hormone imbalances. Other hormone imbalances can also cause erectile dysfunction, such as a testosterone deficiency. While taking bioidentical testosterone is one way to address a testosterone deficiency, this doesn’t do anything to address the cause of the problem. Low DHEA levels are a common cause of low testosterone, and low DHEA levels are usually caused by chronic stress. Sometimes the problem is that testosterone is overconverting into estrogen, causing estrogen dominance. When this is the case then this of course needs to be addressed, and taking natural aromatase inhibitors such as resveratrol (10) and white button mushrooms (11) may help.
3. Improve you stress handling skills. I just mentioned how chronic stress can cause low DHEA levels, which in turn can cause low testosterone levels, thus leading to erectile dysfunction. However, stress and anxiety can also cause erectile dysfunction even if someone has normal testosterone levels, as a few studies have shown a relationship between elevated cortisol levels and erectile dysfunction (12) (13). Either way it is important to do things to improve your stress handling skills, such as meditation, deep breathing, yoga, and biofeedback.
4. Improve your cardiovascular health. Earlier I shared some research which showed that 40% of erectile dysfunction in men over 50 years of age is due to atherosclerosis, and how erectile dysfunction may be considered to be an early marker for cardiovascular disease. This makes sense when you think about it, as adequate blood flow is essential for a penile erection. And if someone has poor cardiovascular health, or a condition such as diabetes, then this will affect the circulation, and thus can lead to erectile dysfunction. Modifying the lifestyle factors can greatly improve cardiovascular health, as you want to eat well, exercise regularly, and do a good job of managing stress.
5. Address the nervous system. Remember that problems with the nervous system can cause erectile dysfunction. Addressing a nervous system imbalance can be challenging, especially if it is due to nerve damage, or a condition such as multiple sclerosis. Being a chiropractor I think it’s important to realize that a misalignment of the spine affecting the nerves can also potentially cause erectile dysfunction. I’m not suggesting that this is a common cause, but it’s something that needs to be considered in some cases.
6. Be aware of medications which might be causing erectile dysfunction. I mentioned how certain medications can lead to erectile dysfunction. This includes beta blockers (14), which many people with hyperthyroidism take to lower their heart rate. Keep in mind that I’m not suggesting for anyone who has erectile dysfunction and is taking a beta blocker to stop taking it, but it definitely would be a good idea to run this by your medical doctor. Plus, the results of some studies show that the knowledge about the side effects of beta blockers can produce anxiety that is responsible for the erectile dysfunction (15).
7. Take nutrients which improve erectile dysfunction. Numerous studies have shown that Korean red ginseng may improve erectile dysfunction (16) (17). The mechanism of action isn’t completely understood, although it might accomplish this by affecting the nitric oxide pathways (18). A vitamin D deficiency can cause many problems, and one study I came across suggested that a vitamin D deficiency can cause erectile dysfunction (19). Other nutrients which might improve erectile dysfunction include arginine, yohimbine, maca, and ginkgo biloba (20).
The way Viagra works is by enhancing signaling through the nitric oxide pathway. This also is how some other nutrients and herbs work, as they increase nitric oxide production. For example, the amino acid arginine is a precursor for the synthesis of nitric oxide. The herb Ginkgo biloba also affects the nitric oxide pathway (21). This is why these can be effective for helping with erectile dysfunction.
In summary, there are numerous factors which can cause erectile dysfunction. With regards to thyroid health, both hypothyroidism and hyperthyroidism can cause erectile dysfunction. Other potential causes include diabetes, high blood pressure, multiple sclerosis, low testosterone levels, certain medications, and even stress and anxiety. Conventional treatment methods usually involve giving medication such as Viagra or Levitra, but these of course don’t do anything to address the cause of the problem. On the other hand, a natural treatment approach will look to address the underlying cause of erectile dysfunction.
