Krysiak Robert, Marek Bogdan, Okopień Bogusław
Endokrynol Pol. 2018;69(1):16-22. doi: 10.5603/EP.a2018.0005. Epub 2018 Jan 10.
Both overt and subclinical hypothyroidism are often accompanied by sexual dysfunction. Despite improving male sexual functioning, levothyroxine treatment does not always restore all its aspects. The aim of this study was to compare male sexual function-ing and depressive symptoms between men with hypothyroidism receiving levothyroxine/liothyronine combination therapy and men receiving levothyroxine alone.
The study population consisted of 21 young levothyroxine-treated men with clinical symptoms of hypothyroid-ism, in whom serum thyrotropin and thyroid hormone levels were within the normal limits. In 11 of these patients, levothyroxine was replaced with levothyroxine/liothyronine combination therapy, while the remaining ones (n = 10) continued levothyroxine treatment. Beyond measuring serum levels of thyrotropin, free thyroxine, free triiodothyronine, and prolactin, before the beginning of the study and six months later, all enrolled patients completed questionnaires evaluating male sexual function (International Index of Erectile Func-tion-15: IIEF-15) and assessing the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II).
The study included 10 patients from each group. At baseline, erectile function, intercourse satisfaction, orgasmic function, sexual desire and overall satisfaction, as well as the total BDI-II score did not differ between both groups. With the exception of an improvement in sexual desire, replacing levothyroxine with levothyroxine/liothyronine combination therapy did not affect sexual functioning and depressive symptoms.
The obtained results suggest that levothyroxine/liothyronine combination therapy has a relatively mild effect on sexual functioning in levothyroxine-treated men with normal thyrotropin and thyroid hormone levels experiencing clinical symptoms of hypo-thyroidism.
显性和亚临床甲状腺功能减退症常伴有性功能障碍。尽管左甲状腺素治疗可改善男性性功能，但并非总能恢复其所有方面。本研究的目的是比较接受左甲状腺素/碘塞罗宁联合治疗的甲状腺功能减退症男性与仅接受左甲状腺素治疗的男性的性功能和抑郁症状。
研究人群包括21名接受左甲状腺素治疗且有甲状腺功能减退临床症状的年轻男性，其血清促甲状腺激素和甲状腺激素水平在正常范围内。其中11例患者将左甲状腺素替换为左甲状腺素/碘塞罗宁联合治疗，其余患者（n = 10）继续接受左甲状腺素治疗。在研究开始前和6个月后，除了测量血清促甲状腺激素、游离甲状腺素、游离三碘甲状腺原氨酸和催乳素水平外，所有纳入患者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）以及评估抑郁症状的存在和严重程度（贝克抑郁量表第二版 - BDI-II）。
每组各有10例患者纳入研究。基线时，两组在勃起功能、性交满意度、性高潮功能、性欲和总体满意度以及BDI-II总分方面无差异。除性欲有所改善外，用左甲状腺素/碘塞罗宁联合治疗替代左甲状腺素对性功能和抑郁症状无影响。
所得结果表明，左甲状腺素/碘塞罗宁联合治疗对接受左甲状腺素治疗、促甲状腺激素和甲状腺激素水平正常但有甲状腺功能减退临床症状的男性的性功能影响相对较小。
