The effect of l-thyroxine treatment on sexual function and depressive symptoms in men with autoimmune hypothyroidism

Abstract

The obtained results suggest that autoimmune hypothyroidism in men is characterized by sexual and mood disturbances and that hypothyroid patients with sexual dysfunction and depressive symptoms benefit from L-thyroxine treatment.

Funkcjonowanie seksualne i objawy depresyjne u młodych mężczyzn z niedoczynnością tarczycy leczonych terapią skojarzoną z zastosowaniem lewotyroksyny i liotyroniny

“…The present findings are in contrast with our previous research, which showed that impaired erection was the only sexual dysfunction observed in men with subclinical hypothyroidism as well as a domain most seriously affected in patients with overt hypothyroidism [9]. Moreover, correlations between erectile functioning and thyrotropin and free thyroid hormone levels were stronger than for the remaining domains of IIEF-15 [9].…”

“…Moreover, correlations between erectile functioning and thyrotropin and free thyroid hormone levels were stronger than for the remaining domains of IIEF-15 [9]. These differences may reflect the direct impact of chronic levothyroxine treatment (participants of the previous study were levothyroxine-naïve) and/or different inclusion criteria.…”

“…The restoration of normal hypothalamic-pituitarythyroid axis activity in men with hypothyroidism and hyperthyroidism improved erectile functioning [1,2]. In our recent study [9], levothyroxine administered to patients with hypothyroidism produced a beneficial effect on the domains of male sexual functioning, the activity of which was disturbed, and the strength of this effect depended on the degree of thyroid hypofunction and thyroid autoimmunity. However, in patients with overt hypothyroidism post-treatment erectile functioning was still worse than in healthy subjects.…”

The effect of testosterone on thyroid autoimmunity in euthyroid men with Hashimoto's thyroiditis and low testosterone levels

“…The study purposely included only men with thyrotropin and free thyroid hormone levels within the reference range. Taking into account that patients with autoimmune hypothyroidism should receive thyroid hormone replacement, as well as that exogenous levothyroxine reduces thyroid antibody titres, excluding men with thyroid hypofunction minimized the possibility that the alleviation of thyroid autoimmunity is a consequence of the effect of levothyroxine (not testosterone) or is secondary to pharmacokinetic or pharmacodynamic interactions between levothyroxine and testosterone. Because the study population consisted of only drug‐naïve subjects, the obtained results cannot be also explained by a modulatory impact of testosterone on other medications found to reduce thyroid antibody titres (vitamin D, selenium, myo‐inositol or statins) …”

“…Moreover, androgens receptors were found in the thyroid gland, testosterone up‐regulated androgen receptors in rats and induced thyrocyte proliferation . Finally, exogenous levothyroxine reduced titres of TPOAb and TgAb in men with autoimmune thyroiditis . Therefore, it is also possible that increased endogenous thyroxine production induced by testosterone administration behaves similarly to exogenous levothyroxine.…”