1 Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences , Poznan, Poland .
2 Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet , Copenhagen, Denmark .
Thyroid. 2018 Oct;28(10):1261-1269. doi: 10.1089/thy.2017.0602. Epub 2018 Aug 21.
This study aimed to characterize the frequency of self-reported thyroid-related impaired sex life in patients with thyroid diseases, to examine its clinical correlates and relationship with overall quality of life (QOL), and to investigate the effect of treatment.
Two separate patient samples with benign thyroid diseases were investigated: a cross-sectional sample (759 women and 118 men) treated at two Danish university hospital outpatient clinics, in 2007-2008, and a longitudinal sample (358 women and 74 men) undergoing treatment at the abovementioned centers, during 2008-2012, evaluated before and 6 months after therapy. The thyroid-specific QOL questionnaire ThyPRO was used to measure patient-evaluated thyroid-related sex life impairment. Biochemical and clinical variables were analyzed (i.e., age, education, degree of thyroid dysfunction, comorbidity, serum thyrotropin, total thyroxine, and triiodothyronine, as well as thyroperoxidase and thyrotropin receptor antibody concentrations). The SF-36 Health Survey was used to analyze the effect of impaired sex life on overall QOL.
In the cross-sectional sample, 36% of women and 31% of men reported what they perceived to be thyroid-attributable impaired sex life. Women with autoimmune thyroid diseases reported more impairment than those with non-autoimmune thyroid diseases. In patients with Graves' disease lower levels of educational attainment and in patients with toxic nodular goiter comorbidities were associated with impaired sex life. Overall QOL was lower in patients with thyroid-related sex life impairment. In the longitudinal sample, 42% of women and 33% of men had impaired sex life at baseline, which improved at 6 months follow-up only in women and, when analyzing individual diagnoses separately, statistically significantly among those with autoimmune hypothyroidism. Sexual impairment was associated with low education in patients with toxic nodular goiter and with high plasma triiodothyronine concentrations in patients with Graves' disease. In autoimmune hypothyroidism, a younger age was associated with sex life impairment.
We found a high frequency of self-reported, thyroid-related sex life impairment in patients with benign thyroid diseases, especially in young women with autoimmune thyroid diseases. Self-perceived impaired sex life persisted in women treated for Graves' disease, suggesting that normalization of thyroid function was not sufficient to restore sexual function.
本研究旨在描述甲状腺疾病患者自我报告的甲状腺相关性生活障碍的频率，研究其临床相关性及其与整体生活质量（QOL）的关系，并探讨治疗的效果。
本研究调查了两个不同的良性甲状腺疾病患者样本：2007-2008 年在丹麦两所大学附属医院门诊接受治疗的横断面样本（759 名女性和 118 名男性），以及 2008-2012 年在上述中心接受治疗的前瞻性样本（358 名女性和 74 名男性），分别在治疗前和治疗后 6 个月进行评估。使用甲状腺特异性生活质量问卷 ThyPRO 来衡量患者自我评价的甲状腺相关性生活障碍。分析了生化和临床变量（即年龄、教育程度、甲状腺功能障碍程度、合并症、血清促甲状腺激素、总甲状腺素和三碘甲状腺氨酸，以及甲状腺过氧化物酶和促甲状腺激素受体抗体浓度）。使用 SF-36 健康调查分析了性生活障碍对整体生活质量的影响。
在横断面样本中，36%的女性和 31%的男性报告了他们认为与甲状腺相关的性生活障碍。自身免疫性甲状腺疾病患者报告的性生活障碍比非自身免疫性甲状腺疾病患者更严重。在格雷夫斯病患者中，教育程度较低和伴有毒性结节性甲状腺肿合并症的患者与性生活障碍相关。有甲状腺相关性生活障碍的患者的整体生活质量较低。在前瞻性样本中，基线时有 42%的女性和 33%的男性存在性生活障碍，仅在女性中，在 6 个月的随访中得到改善，而且在单独分析各诊断时，在自身免疫性甲状腺功能减退症患者中，统计学上显著改善。在毒性结节性甲状腺肿患者中，性生活障碍与教育程度较低有关，在格雷夫斯病患者中，与血浆三碘甲状腺氨酸浓度较高有关。在自身免疫性甲状腺功能减退症患者中，年龄较小与性生活障碍相关。
我们发现良性甲状腺疾病患者中自我报告的甲状腺相关性生活障碍的发生率很高，尤其是年轻的自身免疫性甲状腺疾病女性患者。接受格雷夫斯病治疗的女性自我感知的性生活障碍持续存在，这表明甲状腺功能正常化不足以恢复性功能。
