Krysiak Robert, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Pharmacol Rep. 2017 Jun;69(3):432-437. doi: 10.1016/j.pharep.2017.01.005. Epub 2017 Jan 17.
Thyroid autoimmunity and mild hypothyroidism in women seem to be associated with sexual dysfunction and depressive symptoms. Data concerning similar associations in men are limited. The aim of this study was to investigate sexual functioning and depressive symptoms in men with autoimmune hypothyroidism.
The study population consisted of three groups: men with autoimmune overt hypothyroidism (group A), men with autoimmune subclinical hypothyroidism (group B) and healthy euthyroid males without thyroid autoimmunity (group C). Apart from measuring serum levels of thyrotropin and free thyroid hormones and thyroid antibody titers, all included patients completed a questionnaires evaluating male sexual function (International Index of Erectile Function-15: IIEF-15) and assessing the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II) before and after 6 months of levothyroxine treatment.
Men with overt hypothyroidism obtained lower scores in all five domains of IIEF-15, while men with subclinical hypothyroidism only in erectile function. The total BDI-II score was higher in groups A than in groups B and C, as well as higher in group B than in group C. L-thyroxine improved erectile function and normalized intercourse satisfaction, orgasmic function, sexual desire and overall satisfaction in group A, as well as normalized erectile function in group B. In group A, L-thyroxine reduced, while in group B tended to reduce total BDI-II.
The obtained results suggest that autoimmune hypothyroidism in men is characterized by sexual and mood disturbances and that hypothyroid patients with sexual dysfunction and depressive symptoms benefit from L-thyroxine treatment.
女性甲状腺自身免疫和轻度甲状腺功能减退似乎与性功能障碍和抑郁症状有关。关于男性类似关联的数据有限。本研究的目的是调查自身免疫性甲状腺功能减退男性的性功能和抑郁症状。
研究人群包括三组：自身免疫性显性甲状腺功能减退男性（A组）、自身免疫性亚临床甲状腺功能减退男性（B组）和无甲状腺自身免疫的健康甲状腺功能正常男性（C组）。除了测量血清促甲状腺激素、游离甲状腺激素水平和甲状腺抗体滴度外，所有纳入患者在左甲状腺素治疗6个月前后均完成了评估男性性功能的问卷（国际勃起功能指数-15：IIEF-15）和评估抑郁症状的存在及严重程度的问卷（贝克抑郁量表第二版 - BDI-II）。
显性甲状腺功能减退男性在IIEF-15的所有五个领域得分较低，而亚临床甲状腺功能减退男性仅在勃起功能方面得分较低。A组的BDI-II总分高于B组和C组，B组也高于C组。左甲状腺素改善了A组的勃起功能，并使性交满意度、性高潮功能、性欲和总体满意度恢复正常，同时使B组的勃起功能恢复正常。在A组中，左甲状腺素降低了BDI-II总分，而在B组中则有降低BDI-II总分的趋势。
所得结果表明，男性自身免疫性甲状腺功能减退的特征是性和情绪障碍，并且患有性功能障碍和抑郁症状的甲状腺功能减退患者可从左甲状腺素治疗中获益。
