Hyperthyroidism: A Risk Factor for Female Sexual Dysfunction

Abstract

Introduction Hyperthyroidism is a common hormonal disorder in women that may cause female sexual dysfunction (FSD). Aim To assess sexual function in women with hyperthyroidism. Methods A total of 40 women with clinical hyperthyroidism and 40 age-matched voluntary healthy women controls were included in the study. All the subjects were evaluated with a detailed medical and sexual history, including a Female Sexual Function Index (FSFI) questionnaire for sexual status and the Beck Depression Inventory (BDI) for psychiatric assessment. Main Outcomes Measures The levels of serum thyroid-stimulating hormone (TSH), thyroid hormones, sex hormone binding globulin (SHBG), total testosterone (tT), free testosterone (fT), prolactin, estradiol, follicle-stimulating hormone, and luteinizing hormone were measured. Results The mean total FSFI scores were 24.2 ± 9.96 in the hyperthyroidic group and 29 ± 10.4 in the control group (P < 0.0001). Desire (P < 0.040), arousal (P < 0.0001), lubrication (P < 0.0001), orgasm (P < 0.0001), satisfaction (P < 0.0001), and pain (P < 0.007) domain scores were also significantly lower in women with hyperthyroidism. The mean BDI score for hyperthyroidic patients was significantly greater than the score for the control group (P < 0.0001). The mean SHBG level in the hyperthyroidic group was found to be significantly higher than the level in the controls (P < 0.0001), whereas the mean fT level in the hyperthyroidic group was lower than in the control group (P < 0.0001). The FSFI score showed a significant negative correlation with the serum SHBG (r = −0.309, P = 0.005), free triiodothyronine (r = −0.353, P = 0.006) and free tetraiodothyronine (r = −0.305, P = 0.018) levels, BDI scores (r = −0.802, P = 0.0001) and positive correlation with tT (r = 0.284, P = 0.011), fT (r = 0.407, P = 0.001), and TSH (r = 0.615, P = 0.0001) levels. Conclusions A significant percentage of women with clinical hyperthyroidism had sexual dysfunction. Increased depressive symptoms, increased SHBG level, and decreased fT levels were all found to be associated with FSD in clinical hyperthyroidism.

TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis

“…Alternative biomarkers to assess the supply of the organism with thyroid hormones include resting heart rate and other determinants of cardiac output [384, 385], oxygen consumption [386, 387], respiratory quotient [388, 389], thermogenesis [26, 390–392], methylhistidine excretion [393–397] and plasma levels of lipids [398, 399], SHBG [400–405], sclerostin [406], ceruloplasmin [407], lead [408], copper [407–410], arsenic [408], or MBL [411, 412]. These parameters have not been well evaluated, however, and due to the fact that they are subject to multiple extrathyroidal influencing factors they are not expected to deliver superior results as diagnostic tools.…”

MANAGEMENT OF ENDOCRINE DISEASE: Female sexual dysfunction for the endocrinologist

“…A single study has investigated female sexual function in acromegaly patients (22) using FSFI. SD was present in 68% of patients with acromegaly compared to 28% of healthy women, and all FSFI domains scores were significantly lower in acromegalic patients than among controls (22) (25,27,28), whereas it is higher -around 44-60% -in hyperthyroidism (29,30,31).…”

“…In the last few years, different papers showed a correlation between hyperthyroidism and SD in women with case control studies (29,30,31,35) (Table 3). Their major limitation is the fact that these are small studies, but they all showed the same result, therefore confirming the association between clinically-evident thyroid pathology and SD.…”

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

“…65 Overt [66][67][68] or subclinical 66,69 hypothyroidism and hyperthyroidism have been associated with reduced sexual desire. 68,70 Conversely, polycystic ovary syndrome is often characterized by clinical and/or biochemical signs of hyperandrogenism, with or without oligoovulation or anovulation, or polycystic ovaries. Women with polycystic ovary syndrome have psychological (feeling less attractive, less feminine, more depressed) and biological (obesity and infertility) factors that may negatively influence their sexual desire.…”