Effects of hypothyroidism on lower urinary tract symptoms, testosterone and sexual function in men
Jeh, SU1; Yoon, S1; Seo, DH2; Lee, SW1; Lee, C2; Choi, SM1; Kam, SC2; Chung, KH2; Hwa, JS1; Do, J1; Hyun, JS1
1: Gyeongsang National University Hospital, Korea, South; 2: Gyeongsang National University Changwon Hospital
Objectives: Although the effects of thyroid hormones on female gonadal function have been clearly established, the impact of these disorders on male sexual function and lower urinary tract symptoms remains controversial. We evaluated the sexual function and lower urinary tract symptoms (LUTS) and its possible association with hypothyroidism in male subjects.
Materials and methods: Clinical records of 1095 consecutive male patients who had visited our hospital for health screening between January 2010 and July 2016 were assessed. All patients were evaluated serum prostate-specific antigen (PSA), serum total testosterone, thyroid stimulating hormone (TSH), free T4, transrectal ultrasonography and a compilation of the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) questionnaires. To evaluate the impact of hypothyroidism on male sexual function and LUTS, age adjusted multivariate analysis was performed. Hypothyrodism was defined as TSH greater than 4.0 mU/liter or on thyroxine treatment.
Results: Of 1,095 men, 90 (8.2%) had hypothyroidism. Univariate analysis demonstrated that levels of serum testosterone, IIEF sexual desire scores and IIEF overall satisfaction scores were negatively associated with the hypothyroidism, while prostate volumes was positively associated with the hypothyroidism. After adjusting for age, IIEF sexual desire scores (OR 0.90, P = 0.046) and levels of serum testosterone (OR 0.85, P = 0.021) were significantly associated with the prevalence of hypothyroidism. Prevalence of hypogonadism was 13.8% in patients with hypothyroidism vs 6.5% in normal thyroid function group (P = 0.002).
Conclusions: Serum testosterone level and sexual desire were decreased in male hypothyroidism patients. Therefore, it is important to identify and treat hypothyroidism when treating hypogonadism in clinical practice.
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