Solutions to Increase Low Libido in Those with Hashimoto’s

Among the many symptoms of thyroid disease, there is one in particular that significantly impacts people’s relationships and overall happiness, yet it’s a symptom people seldom seek help for: the very common symptom of low libido (low sex drive). In general, libido concerns are something we keep to ourselves. Talking about sex makes us blush and isn’t really socially acceptable in our society – thus, many people suffer in silence. But let’s face it… without libido, we would not survive as a species. 🙂

While low libido may not seem like it would be a symptom caused by thyroid issues, it can be.

In fact, research has shown that women with thyroid disease experience a higher prevalence of low libido at some point in their lives. This goes for the men, too – with some 64 percent of hypothyroid men suffering from diminished libido, along with other sexual function issues (such as erectile dysfunction, delayed ejaculation, and sperm abnormalities).

Fortunately, through many of the lifestyle changes that will help to address thyroid issues, we can also improve libido, as well as overall sexual function, for both women and men. Additionally, there are specific measures you can take to impact libido directly.

So let’s talk more about this… What are the specific causes of low libido, and how does having Hashimoto’s increase your risk?

In this article, you’ll learn:

• Common causes behind having low libido (and how the thyroid can affect this)
• Why conventional approaches to low libido don’t typically work in those with Hashimoto’s
• Natural solutions to increase low libido in both men and women

What is Libido, and What Can Decrease It?

Libido is one’s sex drive, or one’s interest in sexual activity. Libido naturally ebbs and flows, but may decline as the result of many things. For example, it can decline if someone is stressed out or simply tired much of the time.

While having a low libido can be temporary, sometimes it may linger on. Diminished libido can be the byproduct of erectile dysfunction in men, vaginal dryness in women, or hormone imbalance. In particular for women, times of hormone fluctuation, as seen with menstruation, taking birth control pills, transitioning to menopause, or even pregnancy and breastfeeding, can result in an impact on libido. As any pregnant woman will likely report, hormone levels can make a BIG difference in libido.

A low sex drive can also be caused by a number of chronic health conditions, including thyroid and autoimmune diseases. For example, many women who have Polycystic Ovarian Syndrome (PCOS) have shared with me their own challenges with having a low sex drive.

Low libido can be a double whammy for those in current relationships, as they may feel frustrated and inadequate about themselves, as well as feel like they are somehow letting their partner down. It can be quite devastating to a couple’s intimacy and sense of connection.

Having little or no interest in sex can be a difficult topic to talk about (whether that conversation is with a partner or a physician!), so many people remain silent.

Unfortunately, when sex is brought up with a physician, it is often related to a specific physical symptom (e.g. erectile dysfunction or vaginal dryness) versus a discussion focused on one’s sexual desire. The topic is just too embarrassing for many people (and some physicians, I might add!). I truly believe, however, that a few questions about libido at regular health exams could really help many people.

Common Causes of Low Libido

Many of the root causes of low libido can be worsened by having a thyroid condition such as Hashimoto’s. By the end of this article, you’ll be better able to see the numerous connections between the major causes of low libido and thyroid disease.

Here are some common causes of low libido (and remember… all of these causes can be addressed and improved upon!):

Psychological Stress

One cause for low libido may have to do with a person’s body image or relationship itself, which can lead to psychological stress. When a person has body image issues, such as feeling overweight or unattractive, it can lead them to have a lack of interest in sex. Feeling sick and tired, overwhelmed or stressed… all these feelings can easily take one out of the mood.

Or, if a person loses trust in their partner, that can be a “turn-off” and result in a lack of interest in having sex. It’s amazing what our bodies can tune into. Some women I’ve worked with have had “libido problems” that were the result of a partner who was cheating or being abusive. One woman didn’t even know that her partner was cheating, but somehow her body did… crazy, right?

Furthermore, if a man or woman is experiencing sexual “performance” problems (erectile dysfunction, premature ejaculation, inability to orgasm, etc.), it can create a lot of stress around sex due to “performance anxiety”, resulting in a diminished libido, possibly for both partners.

All types of stress (work, family, lack of quality sleep) can play into whether an individual will feel “in the mood”, or just feel moody. A new baby in the house, while totally wonderful and snuggly, can cause a stress of its own (or just a complete lack of sleep and self-care!). For me, it took a few months to adapt to our expanded family’s new routine, along with less sleep and much less productivity!

Remember that ongoing, chronic stress of any kind can also lead to adrenal fatigue, which is the result of too much of our stress hormone, cortisol. (I’ve found that 90 percent of my clients with Hashimoto’s have some degree of adrenal dysfunction; stress is definitely a common trigger for Hashimoto’s.)

How does adrenal fatigue impact libido? When it occurs, the body thinks it’s in survival mode instead of thriving mode. Consequently, the adrenal glands can divert the production of “nice to have” hormones (like progesterone) from seemingly unneeded systems such as the body’s reproductive system, to fuel survival via the production of cortisol (a hormone required for survival). This makes sense – if we’re in survival mode, our bodies are too stressed out to worry about procreation, so no need for libido.

This follows with my Izabella Wentz Safety Theory, which is that from an evolutionary standpoint, our bodies continually adapt to our environment – even developing a chronic disease like Hashimoto’s – to help protect us. We develop Hashimoto’s because we aren’t eating well, or we’re experiencing too many toxins, food sensitivities, stressors, infections, and the like. Our bodies go into survival mode in such cases. Hypothyroidism may then lower our libido, make us less fertile, and possibly make us less attractive to potential partners (we may experience an increase in body weight, hair loss, dull skin, etc.).

Postpartum Issues and Prolactin Levels

As a new mom, I believe that this “protective” mechanism contributes to postpartum thyroid issues. Elevated prolactin levels, which are found in breastfeeding moms, are known to perpetuate auto-antibodies and reduce libido. This could be a way of evolution preventing us from having too many babies all at once! Interestingly, women (and men) with Hashimoto’s who are not breastfeeding tend to have more frequent elevations in prolactin compared to people without Hashimoto’s. Studies have found that up to 20 percent of people with subclinical hypothyroidism may have elevated prolactin levels.

Breast tenderness, milky discharge from breasts outside of breastfeeding/pregnancy, enlarged breasts in males, libido issues, acne, excessive hair, infertility, and menstrual irregularities may all be clues that your prolactin is elevated. A few years ago, I had a few clients with documented elevations in prolactin, and I have seen that lowering prolactin levels can help with reducing thyroid antibodies. Studies have documented that bromocriptine, a medication used to lower prolactin levels, can reduce flares in Lupus, another autoimmune condition.

It’s worth mentioning that sometimes, this elevation of prolactin may be due to a small benign tumor on the pituitary gland, known as a prolactinoma.

In place of bromocriptine, I have previously utilized an integrative protocol of:

• High dose vitamin B6, 300 mg twice daily – Some options I like include Pyridoxine HCl 100 mg by Douglas Labs, and P5P 50 mg by Pure Encapsulations (P5P is the activated version of B6). Klaire Labs also offers a high dose of B6 that contains 250 mg.
• Vitex (Chaste Tree), one capsule, twice daily (may shrink prolactinomas)
• And in some cases, L-Tyrosine, 500-1500 mg, daily

One study found a normalization of prolactin levels with the return of menses within 37-94 days of starting just vitamin B6. Some women who are weaning their nurslings will report that B6 can help suppress milk production as well. Boswellia (Frankincense) may also help with lowering prolactin levels. I recommend measuring prolactin levels within one month of starting to see if improvement has occurred. Please note, you would not want to take Vitex or L-Tyrosine concurrently with bromocriptine, due to drug-herb interactions. (All affect dopamine prolactin production!)

Exacerbated Stress Due to Thyroid Symptoms

Another thing to consider is that thyroid symptoms can exacerbate stress. Many of the common symptoms of thyroid disease, such as hair loss and weight gain, can exacerbate the self-esteem, low energy, and sexual performance issues, often seen with low libido. Again, studies have shown a higher prevalence of sexual performance and libido issues in both men and women with thyroid disease.

Physical Symptoms

There are also many physical symptoms that can be at the root of a low libido. Pain is probably one of the biggest ones that my clients report impacting their quality of life, in and out of the bedroom.

Women who used to work out or enjoy a particular sport may no longer do so if they start experiencing some type of ongoing pain. They may also be told that being physically active again could worsen a medical condition, such as high blood pressure or coronary artery disease. Other chronic health conditions, like arthritis or even lower back pain, can sometimes affect us, or our partner’s, ability to enjoy intimacy.

The good news here is that these conditions have, at their foundation, issues relating to inflammation, and inflammation can be addressed. N-Acetyl Cysteine (NAC) and turmeric/curcumin are just two supplements to consider relating to inflammation and pain reduction (and may result in possible improvements in thyroid antibodies as well).

Women may also experience a wide variety of vaginal and pelvic pain. This list of possible issues is long (ovarian cysts, endometriosis, pelvic floor dysfunction, menstrual irregularities, vaginal dryness, yeast infections, and more), but know that most of these conditions can be significantly improved upon or even resolved. As an example, just by treating their thyroid, many women see improvements with lubrication, libido, and pain.

Finally, let’s talk about a lack of quality sleep, which I mentioned earlier as a stress factor, especially for all new moms (and dads). There have been some really interesting studies done relating to the importance of sleep in having a healthy sexual desire. Sleep deprivation can cause mood changes, irritability, and fatigue, which can impact whether someone feels frisky or not.

Thyroid issues may increase your risk for inflammation as well as sleep apnea. Interestingly, I have seen – with both clients and readers – that there is a very high incidence of people with Hashimoto’s also having sleep apnea. The good news is that there are protocols to address this condition. I’ve seen clients not only get a better night’s sleep on a consistent basis, but also reduce their cortisol levels (and, in doing so, better support their adrenals), by addressing sleep apnea.

Hormone Changes

Another common cause of low libido has to do with the natural fluctuations of our sex hormones, which need to be balanced, along with our adrenal hormones and mindset, in order for us to look forward to, and enjoy, intimacy.

Let’s start with drops in sex drive in women.

We know that women’s sex hormones fluctuate throughout various events and periods (no pun intended ;-)) in our lives (and much – although not all – of this is by design and perfectly normal), including:

• Throughout the menstrual cycle
• When using hormonal birth control pills
• When having a hormone imbalance condition, such as PCOS
• During pregnancy
• While breastfeeding
• During the transition to perimenopause (declines starting in our 30s) and menopause

In most studies that have been done, libido peaks at the time of ovulation in normally cycling women who are menstruating. (This makes sense from an evolutionary standpoint, as that is the most likely time for a woman to get pregnant, so she needs to be at her friskiest.) I still remember when I first got off of hormonal birth control pills and was tracking my cycles. It was so interesting to notice that my husband smelled really, really good after a jog around the time of my ovulation!

At this time, our testosterone is elevated, which increases our libido. This shows how wonderfully our bodies were designed: our libido increases right as a new egg requiring fertilization is released by our ovaries.

Later in our cycle, however, we may experience libido-busting premenstrual symptoms, like PMS, irritability and cramping. This is a time when our progesterone levels dive after no egg fertilization occurs. It may be perfectly normal for a woman to have a decrease in libido during this time. However, every woman is unique in their cycle (especially when it comes to cycle length, the severity of hormonal changes, and associated symptoms!), so if you are concerned as to how you are feeling, bring that up to your doctor.

When using hormonal birth control pills, a woman’s production of natural estrogen and progesterone become suppressed. Levels of testosterone and DHEA (our two libido supporting hormones) also get suppressed, and ovulation basically turns off. This can cause a lot of side effects such as low libido, as well as a variety of hormone imbalances.

The process of aging causes changes in our sex hormone levels (including estrogen, progesterone, testosterone, and DHEA) over time as well, starting as early as our 30s. This is all perfectly normal for the most part… but there can be issues relating to hormonal imbalance along the way, such as with PCOS.

PCOS is a challenging condition that is characterized by menstrual irregularities, infertility, insulin resistance, and a variety of symptoms such as fatigue, excess weight, stress, hair loss, or excessive hair growth. Women having PCOS are three times more likely to be diagnosed with Hashimoto’s. Just like with thyroid disease, PCOS is associated with an increased risk for anxiety and depression disorders; and some women with PCOS experience libido concerns.

The condition is tied to sex hormone imbalances – in particular, higher than normal androgen levels, which can prevent ovulation. Many of the same suggestions I would offer for someone having thyroid concerns relating to libido may help with PCOS, including managing insulin resistance. (Myo-inositol may also help improve insulin sensitivity, as well as mood).

Trying to get pregnant when hormones are imbalanced, especially if you have a thyroid issue, can require some special care. Once pregnant, libido may be affected due to changing hormones. Many women suffer from fatigue, a feeling of unattractiveness, and fears of the future, as they progress through their pregnancy. Often, a woman’s libido kicks into high gear at the end of the first trimester (after hormone havoc takes over her body with estrogen and progesterone levels increasing, which can also cause symptoms such as nausea and fatigue early on)… but then declines in the third trimester.

By the time women reach menopause, their testosterone levels may be reduced to only a quarter of what they were in their early – and friskier – 20s. Declines in estrogen, testosterone and DHEA can also result in vaginal dryness, painful intercourse, and incontinence (involuntary urinary leakage) – all significant libido busters. But all are conditions which can be resolved.

Symptoms of menopause can also contribute to a diminished sex drive. Hot flashes, night sweats, and poor sleep have been frequently reported in studies relating to decreased sexual desire. Many of my clients complain about these symptoms and their impact on relationships! The good news is that many of the same lifestyle interventions I recommend for thyroid health, such as adrenal support, improve these menopausal symptoms as well.

As progesterone and estrogen decline in menopause, the ratio of estrogen levels to progesterone levels can negatively impact the production of DHEA. If the ratio of progesterone becomes insufficient compared to estrogen, the resulting condition is called “estrogen dominance.” This can cause mood swings, anxiety, and weight gain in women. (Learn more about how estrogen dominance can affect thyroid health.)

Men are not exempt from experiencing declines in their sex hormone levels as they grow older.

In men, free testosterone levels peak in their 20s and decline by about one percent per year in their 30s. Symptoms linked to low testosterone include low libido, as well as a number of symptoms that are also seen in menopause (such as mood swings, anxiety, and depression). Men may suffer from erectile dysfunction (ED) as well. (I’ll talk a bit about Viagra in a moment, as this drug is often prescribed for ED in men, but does not always help with libido issues.)

Thyroid issues can increase the decline in sex hormone production. Both our sex and thyroid hormones are part of an overall hormone communications network in our body, referred to as the HPA (Hypothalamic-Pituitary-Adrenal) axis. A sluggish thyroid can reduce the production of sexual hormones required for optimal sexual function and a healthy libido.

The common issue mentioned earlier, estrogen dominance, can be a trigger for autoimmune conditions in both men and women. Estrogen dominance can also worsen hypothyroid symptoms by increasing the activity of Thyroxine Binding Globulin (TBG) hormone, which further reduces levels of free thyroid hormone in our bodies.

Hypothyroidism in men results in a decrease in sexual hormone binding globulin (SHBG) – a protein made by the liver that binds to androgens and estrogens – with free testosterone reduced in approximately 60 percent of males. Reduced testosterone production can lead to symptoms such as infertility, erectile dysfunction, low libido, and reduced muscle mass.

We’ll talk about how to address these hormonal imbalances shortly. There are many natural solutions.

Mood and Emotions

We’ve likely all used the phrase, “I’m not in the mood tonight.”

Well, mood can definitely be a root cause for low libido. We talked earlier about how a lack of sleep can cause irritability and moodiness. Other negative emotions can also cause problems, and bottling things up inside can often magnify your concerns. For some people, this can result in a case of the blues.

We know from the research that people who are depressed are more likely to experience low libido. One study found that more than 70 percent of depressed patients, who were not taking depression medications, had a loss of sexual interest.

Some anti-depressants, including Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), can cause lowered libido as well. In my experience as a pharmacist, these side effects were very common, and psychiatrists would sometimes prescribe a second antidepressant with a different mechanism of action, Wellbutrin, to counteract the sexual side effects of these medications.

While many of my clients say they like to do some serious cocooning (hiding away from everyone and just hunkering down alone) when they are feeling down, my own belief is that this is really the time one most needs their loved ones and a sense of community. If you don’t feel you can reach out to your partner (at the particular moment), grab a friend and do some positive bonding that way. Did you know that our bonding and hormone of love, oxytocin, helps counter the negative effects of our stress hormone, cortisol? Yes, it does!

Finally, it’s important to note that anxiety and mood disorders have a higher prevalence in patients with thyroid dysfunction. In my own practice, I have found that mood disorders are very common in those with thyroid conditions. Many studies have associated abnormal levels of TSH, T3, and T4, with depression. You can read more about that, along with my personal experience, in my articles on anxiety and mood disorders related to Hashimoto’s.

Conventional Approaches to Addressing Low Libido

People don’t often bring up the topic of low libido with their doctor. In a 2018 poll conducted by researchers from the University of Michigan, only 17 percent of adults said they had discussed their sex life with their doctor!

If the issue is brought up, today’s conventional approach is definitely lacking. Some will at least review existing medications, in particular those prescribed for depression and anxiety, and switch out any with known effects. Others may suggest reducing stress, getting relationship counseling, and spicing things up in the bedroom.

There are also a few typical standard-of-care protocols that may be recommended. Let’s talk briefly about what’s available for women and men.

Conventional Approaches for Women

For women, a so-called “female sex pill”, flibanserin (Addyi), exists, but it has not had a lot of positive results, especially given its limited benefit along with numerous side effects. The potential benefit? One more day of increased sexual desire per month. The side effects for this additional day? The possibility of low blood pressure, dizziness, nausea, and fatigue on a daily basis! Additionally, alcohol (known as the original libido booster by some) is not recommended while a woman is taking this medication. I’ve talked to a lot of practitioners at conferences, and no one has been excited about this as a viable solution.

Other possible treatments include hormone therapies such as estrogen hormone replacement therapy. Estrogen doesn’t really “fix libido”, but may address symptoms such as hot flashes and vaginal dryness, which can impact libido. Unfortunately, there are potential side effects and health risks (related to breast cancer), so this option isn’t right for a lot of women.

Androgen replacement therapies (testosterone and DHEA) are also possible, but are not viewed as conventional therapies by most doctors. I’ll talk more about estrogen and androgen therapies in a moment.

Conventional Approaches for Men

The standard-of-care for low libido in men is often a prescription for Viagra (the blue diamond pill), or a similar type of medication. The issue with Viagra is that it is really a medication that addresses blood flow issues relating to ED. Viagra and other drugs like it do not address other possible root causes for a man having low libido or low testosterone.

Low testosterone can be a risk factor – beyond libido – for many other significant health issues, including diabetes, heart disease, and even cognitive decline. There are ways to naturally support healthier testosterone hormone balance, and I’ll discuss them in a minute.

Natural Solutions to Increase Libido in Both Men and Women

The good news is that addressing thyroid dysfunction can help restore libido and sexual function!

In a recent 2018 study focused on the connection between the thyroid and libido, thyroid hormone levels appeared to be the causative factor for libido and sexual dysfunction issues in men, while thyroid antibodies appeared to play a more important role in low libido in women. This is important information to know, as there are many ways to optimize thyroid hormone levels and reduce thyroid antibodies.

With those two goals in mind, here are a few core recommendations to help you get started on a healthier libido, today:

1. Talk about low libido. You need to talk about libido concerns with both your partner and doctor. For your partner, it is important that they understand what is going on, that it can be improved upon, and that it isn’t (or is) related to issues in your relationship.

For your doctor, it is important that they know if you (or your partner) are experiencing low libido, as it can be a symptom of thyroid disease as well as other health issues, including chronic pain, depression, hypertension, diabetes, and cardiovascular disease. The factors that influence a low libido (lack of sleep, stress, adrenal dysfunction, underlying anxiety issues) should be identified and tackled. Your doctor will also want to evaluate all medications you take, to see if any of them have known libido-related side effects.

Libido health should be a topic for every annual checkup, but not every doctor will ask these types of questions. If you are not seeing a functional medicine practitioner, you might want to find one that will take more of an integrated view of your thyroid health. (Find out more about what a functional medicine practitioner can do for you, and where to find one.)

2. Optimize thyroid medications to improve libido. Sometimes just tweaking your thyroid hormone medication can help. In a 2019 review of existing research, it was found that optimizing thyroid hormone levels was associated with a dramatic resolution of libido (as well as sexual dysfunction) in both male and female patients with hypothyroidism or hyperthyroidism.

We know that thyroid medications have a narrow therapeutic index and that careful dose titration is key to their effectiveness. Doses that are incorrect by even just a tiny amount can result in ongoing or even new symptoms, so it’s important to ensure your current dosage is correct. (You can read more about thyroid hormone medication optimization in this free eBook.)

3. Support your adrenals. First, get tested for adrenal dysfunction. Once you know the status of your adrenal health, you can work to improve it with the Adrenal Recovery Protocol in my book Hashimoto’s Protocol, which focuses on strategies to help you regain your adrenal health, including: improving sleep, balancing blood sugar, stress management, reducing overall inflammation, replenishing key nutrients, and building up resilience with adrenal adaptogens.

Adrenal adaptogens are natural products that supplement the body’s ability to handle stress and are thought to normalize and support the HPA axis. I recommend Rootcology Adrenal Support, which contains adaptogens like ashwagandha and licorice, to promote healthy cortisol levels and rejuvenate the adrenals.

For more in-depth information relating to adrenal support, check out my article on adrenal health.

4. Try maca! The Peruvian herb maca can help support your body’s stress response and optimize adrenal health. It can also help with menopause symptoms that might affect sexual desire, such as night sweats and hot flashes. Furthermore, studies have shown that maca may help improve libido in both women and men. I like the Femmenessence brand, which offers specific formulations for women and men. Please note, maca is an adaptogen. However, it may have different effects on different people, and could be stimulating to some people. I recommend starting with a low dose, to see how you tolerate it, and working your way up.

5. Focus on improving your quantity and quality of sleep. Better sleep will not only help with fatigue and mood, but will also naturally boost your DHEA levels, and therefore your libido. Better sleep will support your adrenals as well. Find my go-to sleep hacks here. (All of these recommendations are applicable to you and your partner. As they say, it takes two to tango!) If you suspect you or your partner might suffer from sleep apnea, please bring that up with your doctor. Treatment can be very effective.

6. Improve mood and reduce anxiety. I recommend incorporating stress management techniques, like massages and journaling, into your daily routine. Reach out to loved ones and your best support community to get a healthy dose of oxytocin each day. (Oh, and just because you might not “be in the mood”, doesn’t mean a little hand-holding or shoulder massage won’t generate some nice levels of oxytocin, for both you and your partner.) You may also consider supplementing with selenium and myo-inositol, which have been shown to improve mood and reduce anxiety in people with Hashimoto’s. These strategies may help reduce symptoms that can act as barriers to intimacy, as well as help in reducing thyroid antibodies, leaving people with an improved sense of well-being… a perfect way to set the mood.

7. Consider sexual hormone replacement therapy. In women, estrogen hormone replacement therapy (HRT) can reduce vaginal dryness and pain during intercourse, as well as reduce hot flashes and night sweats, which could aid in libido improvements. As mentioned previously, this is often prescribed as a conventional standard-of-care treatment. However, estrogen dominance can be a trigger for Hashimoto’s, so caution should be taken if considering this option.

Testosterone therapy is another potential treatment for women and can result in increased vaginal lubrication, heightened sexual arousal, and increased libido.

For men, testosterone hormone replacement therapy is also an option. As mentioned earlier, this is not the same as Viagra. Viagra is focused on improving blood flow to the penis, to address ED. Testosterone, on the other hand, is involved in a multitude of processes throughout the male body. It is involved in protein and muscle formation, helps manufacture bone, control blood sugar, and regulate cholesterol, supports a healthy immune system, aids in memory and mood, and yes, helps men get in the mood. But a healthy testosterone level is about much more than libido, so men should get tested and know their numbers for testosterone, as well as other sex hormones.

There are pros and cons associated with hormone replacement therapies, including breast cancer concerns (with estrogen) and side effects (aggressiveness and skin breakouts from testosterone therapy). You should work with a doctor to discuss what might make the most sense for you or your partner.

Thyroid hormone therapies may have to be tweaked, as sexual hormone replacement may impact thyroid hormone levels. Note that there can still be other root causes for low libido that may not be addressed by these therapies. A functional medicine doctor is trained to look at all of these possibilities, so it’s important to consult with one if you are considering this as an option.

In the meantime, you can check out this interview I did on the topic of hormone replacement therapy to learn more about it.

8. Consider DHEA supplementation. DHEA (dehydroepiandrosterone) is an androgen that has many important functions in the body for both men and women. It makes other sexual hormones (including our other libido-supportive sexual hormone, testosterone), and has been shown to support desire, arousal, and orgasms. One study in women with adrenal fatigue showed increased libido after administration of DHEA. In another study, DHEA supplementation also resulted in a reduction of thyroid antibodies!

The recommended daily dose range is generally 10 to 50 mg for women, and 25 to 100 mg for men. (Women need less DHEA than men.) However, starting low and slowly increasing should always be the approach. Some professionals give women even less DHEA – as low as 2 to 5 mg per day. I have personally found that many women with Hashimoto’s tend to do better with the lower dose range.

CAUTION: DHEA is available without a prescription in the United States and a few other countries, but like other hormone therapies, I always recommend only using DHEA under the guidance of a practitioner, to find the right dosage for you. There can be side effects with taking too much DHEA, so DHEA levels should be tested prior to starting supplementation, and then monitored.

DHEA can also be applied topically, which can be especially helpful for women experiencing vaginal dryness and vaginal discomfort.

Practitioners have used vaginally-applied DHEA to address symptoms typically related to menopause, such as vaginal dryness, vaginal tissue integrity, and pain during intercourse – as well as to address libido concerns.

In 2016, the U.S. Food and Drug Administration (FDA) approved a product named Intrarosa®, which contains the active ingredient prasterone (DHEA). This product was approved to treat women having moderate to severe pain during intercourse. The research supporting DHEA and the approval of Intrarosa® also showed many promising benefits relating to reduced vaginal dryness and irritation, strengthened vaginal musculature, and increased libido.

To date, vaginally-applied DHEA is still only available through prescription, either as Intrarosa® or an off-label customized prescription. However, there is an over-the-counter topical cream for the vulva that has been out on the market for over a year now, developed by a longtime gynecologist, obstetrician, and women’s hormone expert named Dr. Anna Cabeca. Her product, Julva®, is a cream that contains DHEA and other natural, soothing ingredients (Alpine Rose stem cells, coconut oil, vitamin E, emu oil and shea butter). Many women have seen it dramatically improve their vaginal dryness and irritation, as well as their libido.

If you’re interested in trying her cream, I’m excited to announce that she has a special offer available to our community. You can try seven nights of Julva® for free – just pay a small fee to cover shipping costs.

9. Finally, for a healthy libido, decompress and do something to help you get in the mood. We’re all running around with too much to do and too many daily stressors. It is important to take some time each day to decompress, unplug (yes, really!), and pamper oneself.

I like using essential oils and taking a nice warm Epsom salt bath at the end of my day (after reading my baby a bedtime book, of course!). Then I like to do some reading of my own…

I suggest you read a romance novel instead of spending your evening checking emails and Facebook. 🙂 Hashimoto’s advocate Tara West happens to be a (hilarious) romance author… Many women with Hashimoto’s are a part of her fan club and credit her work for helping with libido! Check out her books on Amazon.

If you prefer educational books over romance novels to wind down, and want to learn more about how to improve your libido, Dr. Anna Cabeca, creator of the Julva® cream, has a new book coming out that’s a fantastic read!

Dr. Cabeca has discovered a fast-acting and non-pharmaceutical way to dramatically alleviate symptoms associated with pre-menopausal hormonal fluctuations, including metabolic stall and weight gain, hot flashes and night sweats, insomnia, memory loss, brain fog, irritability, low libido, and painful sex.

The Hormone Fix introduces Dr. Cabeca’s unique Keto-Green™ protocol, a plan that pairs a ketogenic (low-carb/high fat) eating plan with diet and lifestyle changes that bring the body’s cellular pH to a healthy alkaline level. The results are balanced cortisol and insulin, the hormones most responsible for belly fat and weight gain — plus an increase in oxytocin, the “love and happiness” hormone.

The Hormone Fix offers an easy-to-follow program, including:

• A 10-day quick-start detox diet to jump-start weight loss and reduce symptoms
• Daily meal plans and weekly shopping lists to take the guesswork out of a month’s worth of Keto-Green™ eating
• 65 delicious and easy-to-make recipes for breakfast, lunch, dinner, and snacks
• Detailed information on vitamin and mineral supplementation to optimize hormone balance
• Simple self-assessments and recommended lab tests for a better understanding of your hormonal status
• Effective stress-reduction and oxytocin-amplifying techniques

The Takeaway

Many factors can lower one’s libido, and having a thyroid condition can alter it as well. While it can be a difficult subject to discuss, please know that there are strategies you can consider to help improve your libido.

Optimizing thyroid medications, supporting your adrenals, trying maca, improving the quality of your sleep, reducing anxiety levels, decompressing with relaxing daily rituals, and considering hormone replacement therapy are great places to start. You may also wish to consider DHEA, or try the topical cream Julva®, which contains DHEA.

I recommend working with a functional medicine practitioner, who will help you identify the root causes of your low libido. You can download a FREE directory of functional medicine doctors around the world to help you find one in your area.

And don’t forget to include your partner! Maybe he/she needs some pampering, too. 😉

I hope this helps you on your journey!

P.S. For continued updates and interaction, please become a part of our Facebook community and sign up for my newsletter to have helpful information delivered right to your email inbox. You’ll also receive occasional updates about new research, resources, giveaways, and more!

References

1. Pasquali D, et al. Female sexual dysfunction in women with thyroid disorders. J Endocrine Invest. 2013 Oct;36(9):729-33.
2. Carani C, Isidori AM, Granata A, et al. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. J Clin Endocrinol Metab. 2005 Dec;90(12):6472-9.
3. Leiblum S, Bachmann G, Kemmann E, et al. Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones. JAMA. 1983;249(16):2195-2198.
4. Avis NE, Brockwell S, Randolph Jr JF, et al. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women’s Health Across the Nation. Menopause. 2009;16(3):442-452.
5. AlAwlaqi A, Amor H, Hammadeh ME. Role of hormones in hypoactive sexual desire disorder and current treatment. J Turk Ger Gynecol Assoc. 2017;18(4):210-218.
6. Turna B, Apaydin E, Semerci B, et al. Women with low libido: correlation of decreased androgen levels with female sexual function index. Int J Impot Res. 2005 Mar-Apr;17(2):148-53.
7. Guay A, Davis SR. Testosterone insufficiency in women: fact or fiction? Boston University School of Sexual Medicine Website. http://www.bumc.bu.edu/sexualmedicine/publications/testosterone-insufficiency-in-women-fact-or-fiction/. Published February 7, 2003. Accessed 1/19/2019.
8. Smith RL, Gallicchio L, Flaws JA. Factors Affecting Sexual Activity in Midlife Women: Results from the Midlife Health Study. J Womens Health (Larchmt). 2017;26(2):103-108.
9. Woods NF, Mitchell ES, Smith-Di Julio K. Sexual desire during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. J Womens Health (Larchmt). 2010;19(2):209-18.
10. Travison TG, Araujo AB, O’Donnell AB, Kupelian V, McKinlay JB.  A Population-Level Decline in Serum Testosterone Levels in American Men. The Journal of Clinical Endocrinology and Metabolism Website. https://academic.oup.com/jcem/article/92/1/196/2598434. Published January 1, 2007. Accessed January 20, 2019.
11. Hot Flashes and Thyroid Health. Natural Endocrine Solutions Website. https://www.naturalendocrinesolutions.com/articles/hot-flashes-thyroid-health/ Accessed January 19, 2019.
12. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010 Oct;31(5):702-55. doi: 10.1210/er.2009-0041.
13. Thyroid Disorders and Men’s Sexual Health. SexHealthMatters. Sexual Medicine Society of North America Website. https://www.sexhealthmatters.org/sex-health-blog/thyroid-disorders-and-mens-sexual-health/single. Published April 12, 2016. Accessed January 18, 2019.
14. Phillips Jr MD RL, and Slaughter MD JR. Depression and sexual desire. Am Fam Physician. 2000 Aug 15;62(4):782-786.
15. Bathla M, Singh M, Relan P. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. Indian J Endocrinol Metab. 2016;20(4):468-74.
16. Oppo A, Franceschi E, Atzeni F, Taberlet A, Mariotti S. Effects of hyperthyroidism, hypothyroidism, and thyroid autoimmunity on female sexual function. J Endocrinol Invest. 2011;34(6):449-453. doi:10.1007/bf03346712.
17. Veras A, Bruno R, de Avila M, Nardi A. Sexual dysfunction in patients with polycystic ovary syndrome: clinical and hormonal correlations. Compr Psychiatry. 2011;52(5):486-489. doi:10.1016/j.comppsych.2010.10.013.
18. Woods NF, Mitchell ES, Smith-Di Julio K. Sexual desire during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. J Womens Health (Larchmt). 2010;19(2):209-18.
19. Bahar A, e. (2019). Hyperprolactinemia in association with subclinical hypothyroidism. – PubMed – NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24024022 [Accessed 13 Feb. 2019].
20. Palestine, A., Muellenberg-Coulombre, C., Kim, M., Gelato, M. and Nussenblatt, R. (1987). Bromocriptine and low dose cyclosporine in the treatment of experimental autoimmune uveitis in the rat. Journal of Clinical Investigation, 79(4), pp.1078-1081.
21. WEIZMAN, A., WEIZMAN, R., HART, J., MAOZ, B., WIJSENBEEK, H. and DAVID, M. (1983). The Correlation of Increased Serum Prolactin Levels with Decreased Sexual Desire and Activity in Elderly Men. Journal of the American Geriatrics Society, 31(8), pp.485-488.
22. Dogansen, S., Selcukbiricik, O., Bilir, B. and Yarman, S. (2016). The higher incidence of autoimmune thyroid disease in prolactinomas than in somatotrophinomas. Growth Hormone & IGF Research, 29, pp.45-49.
23. Elenkova, A., Petrossians, P., Zacharieva, S. and Beckers, A. (2016). High prevalence of autoimmune thyroid diseases in patients with prolactinomas: A cross-sectional retrospective study in a single tertiary referral centre. Annales d’Endocrinologie, 77(1), pp.37-42.
24. Sirohi, T. and Singh, H. (2018). Estimation of serum prolactin levels and determination of prevalence of hyperprolactinemia in newly diagnosed cases of subclinical hypothyroidism. Journal of Family Medicine and Primary Care, 7(6), p.1279.
25. Qian, Q., Liuqin, L., Hao, L., Shiwen, Y., Zhongping, Z., Dongying, C., Fan, L., Hanshi, X., Xiuyan, Y. and Yujin, Y. (2015). The Effects of Bromocriptine on Preventing Postpartum Flare in Systemic Lupus Erythematosus Patients from South China. Journal of Immunology Research, 2015, pp.1-6.
26. Vieira Borba, V. and Shoenfeld, Y. (2019). Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?. Clinical Rheumatology.
27. Mclntosh, E. (1976). TREATMENT OF WOMEN WITH THE GALACTORRHEA-AMENORRHEA SYNDROME WITH PYRIDOXINE (VITAMIN B6). The Journal of Clinical Endocrinology & Metabolism, 42(6), pp.1192-1195.
28. Mun JK, Choi SJ, Kang MR, et al. Sleep and libido in men with obstructive sleep apnea syndrome. Sleep Med. 2018 Dec;52:158-162. doi: 10.1016/j.sleep.2018.07.016.
29. Barrett-Connor E, Dam TT, Stone K, et al. The association of testosterone levels with overall sleep quality, sleep architecture, and sleep-disordered breathing. J Clin Endocrinol Metab. 2008;93(7):2602-9.
30. Bozkurt N, Karbek B, Cakal E, Firat H, Ozbek M, Delibasi T. The association between severity of obstructive sleep apnea and prevalence of Hashimoto’s Thyroiditis. Endocrine Journal. 2012;59(11):981-988. doi:10.1507/endocrj.ej12-0106.
31. Malani P, Solway, E. Let’s Talk About Sex. National Poll On Healthy Aging. University of Michigan Website. https://www.healthyagingpoll.org/report/lets-talk-about-sex. Accessed January, 19 2019.
32. (Krysiak R, Szkróbka W, Okopień B. The effect of l-thyroxine treatment on sexual function and depressive symptoms in men with autoimmune hypothyroidism. Pharmacol Rep. 2017 Jun;69(3):432-437. doi: 10.1016/j.pharep.2017.01.005.
33. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010 Oct;31(5):702-55. doi: 10.1210/er.2009-0041.
34. Bates JN, Kohn TP, Pastuszak AW. Effect of thyroid hormone derangements on sexual function in men and women. Sex Med Rev. 2018 Nov 17. pii: S2050-0521(18)30108-2. doi: 10.1016/j.sxmr.2018.09.005.
35. Meissner HO, Mscisz A, Reich-Bilinska H, et al. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (III) Clinical responses of early-postmenopausal women to Maca in double blind, randomized, Placebo-controlled, crossover configuration, outpatient study. Int J Biomed Sci. 2006;2(4):375-94.
36. Meissner HO, Reich-Bilinska H, Mscisz A, Kedzia B. Therapeutic Effects of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon) used as a Non-Hormonal Alternative to HRT in Perimenopausal Women – Clinical Pilot Study. Int J Biomed Sci. 2006;2(2):143-59.
37. Dording CM, Fisher L, Papakostas G, et al. A double-blind, randomized, pilot dose-finding study of maca root (L.mevenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008 Fall;14(3):182-91. doi: 10.1111/j.1755-5949.2008.00052.x.
38. Gonzales GF, Córdova A, Vega K, et al. Effect Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002 Dec;34(6):367-72.
39. Montgomery KA. Sexual desire disorders. Psychiatry (Edgmont). 2008;5(6):50-5.
40. Labrie F, Archer DF, Koltun W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016 Mar;23(3):243-56. doi: 10.1097/GME.0000000000000571.