Thyroid hormones and male sexual function

Abstract

The role of thyroid hormones in the control of erectile functioning has been only superficially investigated. The aim of the present study was to investigate the association between thyroid and erectile function in two different cohorts of subjects. The first one derives from the European Male Ageing Study (EMAS study), a multicentre survey performed on a sample of 3369 community-dwelling men aged 40-79 years (mean 60 ± 11 years). The second cohort is a consecutive series of 3203 heterosexual male patients (mean age 51.8 ± 13.0 years) attending our Andrology and Sexual Medicine Outpatient Clinic for sexual dysfunction at the University of Florence (UNIFI study). In the EMAS study all subjects were tested for thyroid-stimulating hormone (TSH) and free thyroxine (FT4). Similarly, TSH levels were checked in all patients in the UNIFI study, while FT4 only when TSH resulted outside the reference range. Overt primary hyperthyroidism (reduced TSH and elevated FT4, according to the reference range) was found in 0.3 and 0.2% of EMAS and UNIFI study respectively. In both study cohorts, suppressed TSH levels were associated with erectile dysfunction (ED). Overt hyperthyroidism was associated with an increased risk of severe erectile dysfunction (ED, hazard ratio = 14 and 16 in the EMAS and UNIFI study, respectively; both p < 0.05), after adjusting for confounding factors. These associations were confirmed in nested case-control analyses, comparing subjects with overt hyperthyroidism to age, BMI, smoking status and testosterone-matched controls. Conversely, no association between primary hypothyroidism and ED was observed. In conclusion, erectile function should be evaluated in all individuals with hyperthyroidism. Conversely, assessment of thyroid function cannot be recommended as routine practice in all ED patients.

Subclinical Hypothyroidism Is Not a Risk Factor for Female Sexual Dysfunction in Korean Middle-Aged Women

“…Endocrine disorders often negatively affect sexual activity, and sexual dysfunction can be a sign of endocrine disease (12). Investigations on this topic have been gradually reported since the 1950s, but most studies on sexual dysfunction have focused on male sexual dysfunction, particularly erectile dysfunction (20,21). Until now, relatively few studies have reported on the relationship between endocrinopathies and female sexual dysfunction.…”

Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

“…Hence, it can be speculated that a back-flow of venous blood from the testis to the prostate can lead to an intrapelvic venous congestion, facilitating the onset of prostatitis symptoms, which in turn can induce the development of PE as previously described 54. On the other hand, an enlarged prostate size could reflect the presence of prostate inflammations/infection, which is one of the most important causes of acquired PE, along with hyperthyroidism 2324545556. Accordingly, the use of alpha-blockers and phosphodiesterase type 5 inhibitors, which might also reduce prostate inflammation,5758 could be beneficial even in subjects with PE 59.…”

Funkcjonowanie seksualne i objawy depresyjne u młodych mężczyzn z niedoczynnością tarczycy leczonych terapią skojarzoną z zastosowaniem lewotyroksyny i liotyroniny

“…Erectile dysfunction has been reported more frequently in men with either hypothyroidism or hyperthyroidism than in men with normal thyroid function [1,2], but after adjusting for potential confounders only frank hyperthyroidism was found to be associated with erectile dysfunction [3]. Unlike erectile function, libido was more disturbed in men with hypofunction than in men with hyperfunction of the thyroid gland [1,4].…”