This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carani, C. Articles by Jannini, E. A. Search for Related Content PubMed PubMed Citation Articles by Carani, C. Articles by Jannini, E. A. Related Collections Thyroid Male Endocrinology

Multicenter Study on the Prevalence of Sexual Symptoms in Male Hypo- and Hyperthyroid Patients

Department of Endocrinology (C.C., A.G.), University of Modena, 41100 Modena, Italy; Department of Endocrinology (A.M.I., A.L.), University of Rome "La Sapienza", 00161 Rome, Italy; Department of Endocrinology (M.M.), University of Florence, 50139 Florence, Italy; and Course of Endocrinology and Medical Sexology at the Department of Experimental Medicine of the University of L’Aquila (E.C., E.A.J.), 67100 L’Aquila, Italy

Address all correspondence and requests for reprints to: Emmanuele A. Jannini, M.D., Course of Endocrinology and Medical Sexology, Department of Experimental Medicine, University of L’Aquila, Coppito, Building 2, Room A2/54, 67100 L’Aquila, Italy. E-mail: jannini{at}univaq.it.

Context: Thyroid hormones have a dramatic effect on human behavior. However, their role on sexual behavior and performance has seldom been investigated in men.

Objective: The objective of this study was to evaluate the prevalence of sexual dysfunctions in patients with hyper- and hypothyroidism and their resolution after normalization of thyroid hormone levels.

Design and Setting: We conducted a multicenter prospective study at endocrinology and andrology clinics in university hospitals.

Patients: The study included 48 adult men, 34 with hyperthyroidism and 14 with hypothyroidism.

Main Outcome Measures: Subjects were screened for hypoactive sexual desire (HSD), erectile dysfunction (ED), premature ejaculation (PE), and delayed ejaculation (DE) on presentation and 8–16 wk after recovery from the thyroid hormone disorder.

Results: In hyperthyroid men, HSD, DE, PE, and ED prevalence was 17.6, 2.9, 50, and 14.7%, whereas in hypothyroid men, the prevalence of HSD, DE, and ED was 64.3% and of PE was 7.1%. After thyroid hormone normalization in hyperthyroid subjects, PE prevalence fell from 50 to 15%, whereas DE was improved in half of the treated hypothyroid men. Significant changes were found in the subdomains of the International Index of Erectile Function; ejaculation latency time doubled after treatment of hyperthyroidism (from 2.4 ± 2.1 to 4.0 ± 2.0 min), whereas for hypothyroid men it declined significantly, from 21.8 ± 10.9 to 7.4 ± 7.2 (P < 0.01 for both). TSH and thyroid hormone levels normalized rapidly after treatment, and changes in circulating sex steroids partially reflected the changes in SHBG levels.

Conclusions: In summary, most patients with thyroid hormone disorders experience some sexual dysfunctions, which can be reversed by normalizing thyroid hormone levels. Despite the associated changes in sex hormone levels, the high prevalence of ejaculatory disorders and their prompt reversibility suggest a direct involvement of thyroid hormones in the physiology of ejaculation.

This article has been cited by other articles:

				M. S. Wagner, S. M. Wajner, and A. L. Maia The role of thyroid hormone in testicular development and function J. Endocrinol., December 1, 2008; 199(3): 351 - 365. [Abstract] [Full Text] [PDF]

				G. A. Brent Graves' Disease N. Engl. J. Med., June 12, 2008; 358(24): 2594 - 2605. [Full Text] [PDF]

				S. M. Wajner, M. dos Santos Wagner, R. C N Melo, G. G Parreira, H. Chiarini-Garcia, A. C Bianco, C. Fekete, E. Sanchez, R. M Lechan, and A. L. Maia Type 2 iodothyronine deiodinase is highly expressed in germ cells of adult rat testis J. Endocrinol., July 1, 2007; 194(1): 47 - 54. [Abstract] [Full Text] [PDF]

				S. Razvi, L. Ingoe, G. Keeka, C. Oates, C. McMillan, and J. U. Weaver The Beneficial Effect of L-Thyroxine on Cardiovascular Risk Factors, Endothelial Function, and Quality of Life in Subclinical Hypothyroidism: Randomized, Crossover Trial J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1715 - 1723. [Abstract] [Full Text] [PDF]

				L. Mascitelli and F. Pezzetta Erectile dysfunction and thyroid disorders. Arch Intern Med, June 26, 2006; 166(12): 1322 - 1323. [Full Text] [PDF]

				L. Mascitelli and F. Pezzetta Erectile dysfunction and incidence of cardiovascular disease. JAMA, May 3, 2006; 295(17): 1998 - 1999. [Full Text] [PDF]