Krysiak Robert, Kowalcze Karolina, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Eur J Obstet Gynecol Reprod Biol. 2019 Mar;234:43-48. doi: 10.1016/j.ejogrb.2018.12.035. Epub 2019 Jan 9.
Despite high prevalence in a female population, surprisingly little is known about sexual functioning of women with thyroid hyperfunction. This study was aimed at assessing female sexual function and depressive symptoms in women with overt hyperthyroidism of autoimmune and non-autoimmune origin.
The study included three age-matched groups of young women inhabiting the Upper Silesia (a selenium-deficient and iodine-sufficient area): individuals with overt hyperthyroidism induced by Graves' disease (group A, n = 31), women with overt hyperthyroidism caused by toxic multinodular goiter or toxic adenoma (group B, n = 30) and women with normal thyroid function (group C, n = 34). Apart from measuring serum hormone levels, serum antibody titers and determining calculated parameters of thyroid homeostasis, all women completed questionnaires evaluating femalesexual function (FSFI) and depressive symptoms (BDI-II).
The mean total FSFI score and all domain scores were lower while the overall BDI-II score was higher in both groups of women with overt hyperthyroidism than in the control group, and correlated with thyrotropin and free thyroid hormone levels, as well as with the SPINA-GT index. The FSFI score as well as domain scores for desire, arousal and sexual satisfaction were lower, while the BDI-II score was higher in group A than in group B. In group A, the total FSFI score, desire, arousal, sexual satisfaction and severity of depressive symptoms correlated with TRAb and TPOAb titers.
The obtained results suggest that excessive thyroid hormone production and thyroid autoimmunity have an additive effect on sexual functioning and mood.
尽管甲状腺功能亢进在女性人群中患病率较高,但令人惊讶的是,对于甲状腺功能亢进女性的性功能却知之甚少。本研究旨在评估自身免疫性和非自身免疫性显性甲状腺功能亢进女性的性功能和抑郁症状。
该研究纳入了居住在上西里西亚(一个缺硒且碘充足的地区)的三组年龄匹配的年轻女性:由格雷夫斯病引起的显性甲状腺功能亢进患者(A组,n = 31)、由毒性多结节性甲状腺肿或毒性腺瘤引起的显性甲状腺功能亢进女性(B组,n = 30)以及甲状腺功能正常的女性(C组,n = 34)。除了测量血清激素水平、血清抗体滴度并确定甲状腺内环境稳定的计算参数外,所有女性均完成了评估女性性功能(FSFI)和抑郁症状(BDI-II)的问卷。
两组显性甲状腺功能亢进女性的FSFI总均分及所有领域得分均低于对照组,而BDI-II总分高于对照组,且与促甲状腺激素、游离甲状腺激素水平以及SPINA-GT指数相关。A组的FSFI得分以及性欲、性唤起和性满意度领域得分均低于B组,而BDI-II得分则高于B组。在A组中,FSFI总得分、性欲、性唤起、性满意度和抑郁症状严重程度与TRAb和TPOAb滴度相关。
所得结果表明,甲状腺激素分泌过多和甲状腺自身免疫对性功能和情绪具有累加效应。