Baylor College of Medicine, Houston, TX, USA.
Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Sex Med Rev. 2020 Apr;8(2):217-230. doi: 10.1016/j.sxmr.2018.09.005. Epub 2018 Nov 17.
Sexual dysfunction affects many people, with 33‒60% of women reporting sexual dysfunction and 8‒52% of men with erectile dysfunction or premature ejaculation. In an effort to determine the constellation of factors responsible for sexual dysfunction, the effect of thyroid hormone derangements has been of recent interest.
To investigate the associations between thyroid hormones and sexual dysfunction in women and men.
Literature was reviewed to examine the effects of hypo- and hyperthyroidism on sexual function.
We present a summary of the effects of thyroid dysfunction on domains of sexual functioning.
Most studies demonstrate that men with hypo- and hyperthyroidism have increased rates of sexual dysfunction, including erectile dysfunction in men with hypothyroidism. However, studies vary on the strength of correlation between hormonal derangement and level of sexual dysfunction. In both men with hyper- and hypothyroidism, treating the thyroid disorder at least partially reverses sexual dysfunction. In contrast, the current literature provides no consensus on the effect of hypothyroidism, hyperthyroidism, or Hashimoto's thyroiditis on female sexual function. In studies that observed increased rates of sexual dysfunction in women with thyroid disorders, correction of the thyroid derangement resulted in resolution of some sexual dysfunction. Studies are also conflicted on whether there is a relationship between the degree of sexual dysfunction and the degree of hormone derangement in women. However, prior work has demonstrated a relationship between thyroid autoantibodies and sexual dysfunction in women.
Thyroid dysfunction is an important factor in the pathogenesis of sexual dysfunction in men and possibly women. Evidence suggests a reversibility of sexual dysfunction with correction of thyroid dysfunction, although the exact pathophysiology of thyroid-mediated sexual dysfunction remains unknown. However, current evidence supports thyroid derangements rather than autoantibodies as the causative factor in men, whereas autoantibodies appear to play a more prominent role in women. Bates JN, Kohn TP, Pastuszak AW. Effect of Thyroid Hormone Derangements on Sexual Function in Men and Women. Sex Med Rev 2020;8:217-230.
性功能障碍影响很多人，有 33%-60%的女性报告有性功能障碍，8%-52%的男性有勃起功能障碍或早泄。为了确定导致性功能障碍的因素组合，甲状腺激素紊乱的影响最近受到关注。
调查甲状腺激素与男性和女性性功能障碍之间的关系。
回顾文献，研究甲状腺功能减退和甲状腺功能亢进对性功能的影响。
我们总结了甲状腺功能障碍对性功能各领域的影响。
大多数研究表明，甲状腺功能减退和甲状腺功能亢进的男性性功能障碍发生率增加，包括甲状腺功能减退的男性勃起功能障碍。然而，关于激素紊乱与性功能障碍程度之间的相关性，研究结果各不相同。在甲状腺功能亢进和甲状腺功能减退的男性中，治疗甲状腺疾病至少部分逆转了性功能障碍。相比之下，目前的文献对于甲状腺功能减退、甲状腺功能亢进或桥本甲状腺炎对女性性功能的影响尚无共识。在观察到甲状腺功能障碍的女性性功能障碍发生率增加的研究中，纠正甲状腺功能障碍可解决一些性功能障碍。关于女性中是否存在性功能障碍程度与激素紊乱程度之间的关系，研究也存在分歧。然而，之前的研究已经证明了甲状腺自身抗体与女性性功能障碍之间的关系。
甲状腺功能障碍是男性和可能女性性功能障碍发病机制中的一个重要因素。有证据表明，纠正甲状腺功能障碍可以逆转性功能障碍，尽管甲状腺介导的性功能障碍的确切病理生理学仍不清楚。然而，目前的证据支持甲状腺功能紊乱而不是自身抗体是男性的致病因素，而自身抗体在女性中似乎发挥更重要的作用。
