Although thyroid conditions are a common health issue, especially among women, they may still go undiscussed. One possible reason: Hypothyroidism can cause some symptoms— like low libido and constipation — that many of us don’t feel comfortable talking about. “Nobody wants to talk about the strange, embarrassing things happening to our bodies,” says Salila Kurra, MD, an endocrinologist and the medical director at Columbia Adrenal Center in New York City.
The good news is that with thyroid medication, these symptoms are relatively easy to resolve. Here are the answers to some of the more embarrassing questions about hypothyroidism.
1. Why am I constipated all the time?
“Constipation is one of the most common symptoms in people with underactive thyroids,” says Dr. Kurra. “Hypothyroidism decreases your gut motility and how fast things actually move through your gut, therefore increasing your risk of developing constipation.”
WHAT TO DO: Try increasing your water and fiber intake, says Susan Spratt, MD, an endocrinologist at Duke Health in Durham, North Carolina. “But remember, do not take fiber or vitamins with thyroid pills,” Dr. Spratt says. “These can affect the thyroid pill and cause it to not be absorbed in the gut.”
2. Why do I have a low sex drive?
Unfortunately, one of the major side effects of an underactive thyroid is low libido. In fact, according to a 2013 study in the Journal of Endocrinology Investigation, female sexual dysfunction occurs in nearly 50 percent of women with hypothyroidism.
WHAT TO DO: Women can see a drop in estrogen after menopause, which can also account for a lower sex drive. What can you do to maintain a healthy sex life? For one, get more shut-eye. More sleep can lead to more sex, according to a 2015 study published in The Journal of Sexual Medicine. The researchers found that women who got an extra hour of sleep were 14 percent more likely to have sex with a partner the following day. Practicing healthy habits like eating well and exercising regularly may also help. And be open with your partner about your needs and desires. You may want to focus on other ways to be intimate, such as kissing, touching, or cuddling.
3. Why are my periods so heavy or irregular?
Hypothyroidism can cause heavy periods — something that can lead to an iron deficiency, which can cause symptoms such as fatigue, shortness of breath, and worsening sleep apnea, explains Spratt. Kurra says that the majority of women with hypothyroidism have normal periods. Some women, however, experience problems with their menstrual cycles that can range from absent or infrequent periods to periods that are more frequent and heavier.
WHAT TO DO: Treating your hypothyroidism should also improve your menstruation symptoms. If you’re having trouble regulating your thyroid hormone levels and your periods are very heavy, talk to your OB-GYN or primary care doctor about taking hormone replacement therapy or using oral contraceptives, which can help regulate your period and prevent more blood loss, says Kurra.
4. My hair is falling out. What can I do to prevent it?
Lack of thyroid hormone leads to a quicker “death,” so to speak, of hair cells, which results in hair loss. “Any time your thyroid is low or high, your hair is affected,” says Spratt. Often, the hair all dies at once, which can be disconcerting for many patients.
WHAT TO DO: “Make sure your calcium, vitamin D, and iron intake is adequate,” recommends Spratt. “Eventually your hair should start to grow in again. If it doesn’t, see your dermatologist for an evaluation for other causes and treatment options.” You should also treat your hair gently and avoid using harsh products that can make dry, thinning hair worse. If you feel self-conscious, talk to your hairdresser about flattering cuts and styles that can disguise hair loss.
5. I keep forgetting things. What’s going on?
Brain fog is often associated with autoimmune disorders like hypothyroidism. “We don’t completely understand why brain fog occurs,” Kurra says. “But with low thyroid hormone levels, we know that it somehow creates a neurological disruption in the brain, which can cause memory loss or brain fog.”
WHAT TO DO: Make sure your B12 and calcium are at normal levels, suggests Spratt. Also, are you snoring? If so, get tested for sleep apnea, which can increase the chances of developing brain fog. If brain fog continues after getting your thyroid levels in check, however, be sure to talk to your doctor about other possible culprits, recommends Kurra.
6. What can I do about a puffy face?
Low thyroid hormone can cause a drop in your body temperature, which can then lead to fluid retention in your face. Luckily, once your thyroid hormone is normalized, the fluid retention will usually disappear.
WHAT TO DO: In addition to regulating the thyroid hormone with medication, Spratt recommends limiting your sodium intake and avoiding alcohol.