Effect of Thyroid Hormone Derangements on Sexual Function in Men and Women

Abstract

Introduction: 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.

Aim: To investigate the associations between thyroid hormones and sexual dysfunction in women and men.

Methods: Literature was reviewed to examine the effects of hypo- and hyperthyroidism on sexual function.

Main outcome measure: We present a summary of the effects of thyroid dysfunction on domains of sexual functioning.

Results: 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.

Conclusion: 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.

Keywords: Erectile Dysfunction; Hyperthyroid; Hypothyroid; Physiological; Premature Ejaculation; Sexual Dysfunction.

Figure 1.

Thyroid axis. Secretion of thyroid releasing hormone (TRH) from hypothalamus causes downstream secretion of thyroid stimulating hormone (TSH) from anterior pituitary then T3 and T4 from thyroid. T3 and T4 cause negative feedback at both the level of the hypothalamus and anterior pituitary.