Hyperthyroidism and erectile dysfunction: a population-based case—control study

Abstract

Dysthyroidism has been highlighted as a common endocrine disorder associated with erectile dysfunction (ED); however, to date, no large-scale population-based study has investigated the association between hyperthyroidism and ED. This case--control study aimed to explore the association between ED and hyperthyroidism using a population-based data set. In total, 6310 adult patients who received new diagnoses of ED were recruited as cases together with 18 930 matched enrollees with no history of ED who served as controls. Conditional logistic regressions were conducted to explore the association between ED and having been previously diagnosed with hyperthyroidism. In total, 569 (2.3%) of the 25 240 sampled subjects had been diagnosed with hyperthyroidism before the index date; hyperthyroidism was found in 207 (3.3%) cases and 362 (1.90%) controls. After adjusting for potential confounding factors, the odds ratio (OR) of prior hyperthyroidism among cases was 1.64 (95% confidence interval ¼ 1.37--1.96, Po0.001) than that of controls. No association was detected between prior hyperthyroidism and ED for the 18--30, 30--39 and X70 age groups. Subjects aged between 60 and 69 years had the highest ORs for prior hyperthyroidism among cases when compared to controls (OR ¼ 1.84; 95% confidence interval ¼ 1.20--2.84; Po0.001). Our study further confirms the existence of an association between ED and prior hyperthyroidism. INTRODUCTIONHyperthyroidism is a condition in which the thyroid produces an excessive amount of thyroid hormone 1 and affects approximately 2% of women, but significantly less in men. 2 A recently conducted prevalence study in Norway found that 0.9% of all Norwegian men over 20 years old in Nord-Trù ndelag had been diagnosed with hyperthyroidism. 3 Graves' disease accounts for 70% of hyperthyroidism cases, with the age of onset most often occurring during young adulthood 1 and is a genetically linked autoimmune disorder in which the body produces antibodies to its own tissues, which in turn cause the thyroid to produce excess of thyroid hormone. The other 30% of hyperthyroidism cases result from other causes, such as toxic nodular goiters, subacute thyroiditis, exposure to iodine from medications or X-ray dyes and postpartum thyroiditis. Whether on account of autoimmune, inflammatory or metabolic sources, 1 the effects of hyperthyroidism have been reported to be associated with sexual impotence among men. 3,4 Furthermore, one recent study has demonstrated that thyroid hormone nuclear receptors in the penis provide the biological basis for the direct action of thyroid hormones on this organ and suggested that physicians should be advised to investigate sexual function in men with thyroid disorders. 5 Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse and is the most common sexual problem among aging male subjects. 6,7 The Massachusetts Male Aging Study reported that 52% of their community-based survey of men aged between 40...

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

“…27 A Taiwanese study by Keller .001) a significant association was observed. 33 In Corona et al's study of both EMAS and sexual medicine clinic populations discussed above, similar rates of overt primary hyperthyroidism in the men with sexual dysfunction and those in the general population were observed (0.2% vs 0.3%). In both populations, overt hyperthyroidism was strongly associated with ED (HR=14 EMAS, HR=16 sexual clinic, p<0.05 both).…”

Endocrinologic Control of Men’s Sexual Desire and Arousal/Erection

“…These associations were confirmed in nested case-control analyses comparing subjects with overt hyperthyroidism with controls matched for age, body mass index, smoking status, and T levels. 56 Similarly, in a retrospective analysis of a health insurance database representative of Taiwan's general population, Keller et al 120 reported that subjects with ED were 1.64 times more likely to have been previously diagnosed with hyperthyroidism compared with control individuals without ED. TH-a and TH-b receptors were described in rat and human corpora cavernosa endothelial cells and SMCs.…”

Limited effect of testosterone treatment for erectile dysfunction caused by high-estrogen levels in rats

“…Erectile function has a complex underlying mechanism affected by several factors. [1][2][3][4] Some recent studies have suggested that one of these factors may be estrogen levels. [5][6][7][8][9][10][11][12] For example, Baser et al 5 suggested that serum estrogen levels are correlated with symptoms of aging in men, and estrogen may therefore have an important role in these symptoms.…”