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Thyroid hormones and male sexual function

机译：甲状腺激素与男性性功能

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The role of thyroid hormones in the control of erectile functioning has been only superficially investigated. The aim of the present study was to investigate the association between thyroid and erectile function in two different cohorts of subjects. The first one derives from the European Male Ageing Study (EMAS study), a multicentre survey performed on a sample of 3369 community-dwelling men aged 40-79years (mean 60±11years). The second cohort is a consecutive series of 3203 heterosexual male patients (mean age 51.8±13.0years) attending our Andrology and Sexual Medicine Outpatient Clinic for sexual dysfunction at the University of Florence (UNIFI study). In the EMAS study all subjects were tested for thyroid-stimulating hormone (TSH) and free thyroxine (FT4). Similarly, TSH levels were checked in all patients in the UNIFI study, while FT4 only when TSH resulted outside the reference range. Overt primary hyperthyroidism (reduced TSH and elevated FT4, according to the reference range) was found in 0.3 and 0.2% of EMAS and UNIFI study respectively. In both study cohorts, suppressed TSH levels were associated with erectile dysfunction (ED). Overt hyperthyroidism was associated with an increased risk of severe erectile dysfunction (ED, hazard ratio=14 and 16 in the EMAS and UNIFI study, respectively; both p<0.05), after adjusting for confounding factors. These associations were confirmed in nested case-control analyses, comparing subjects with overt hyperthyroidism to age, BMI, smoking status and testosterone-matched controls. Conversely, no association between primary hypothyroidism and ED was observed. In conclusion, erectile function should be evaluated in all individuals with hyperthyroidism. Conversely, assessment of thyroid function cannot be recommended as routine practice in all ED patients.
机译：甲状腺激素在控制勃起功能中的作用只是表面的研究。本研究的目的是研究两个不同人群的甲状腺与勃起功能之间的关系。第一个来自欧洲男性老龄化研究（EMAS研究），该研究是对3369名40-79岁（平均60±11岁）的社区居民男性进行的一项多中心调查。第二个队列是一系列连续3320名异性恋男性患者（平均年龄51.8±13.0岁），他们在佛罗伦萨大学性病科室接受男科学和性医学门诊诊治（UNIFI研究）。在EMAS研究中，对所有受试者的甲状腺刺激激素（TSH）和游离甲状腺素（FT4）进行了测试。同样，在UNIFI研究中检查了所有患者的TSH水平，而仅当TSH结果超出参考范围时才检查FT4。在EMAS和UNIFI研究中，分别发现明显的原发性甲亢（根据参考范围，TSH降低和FT4升高）。在这两个研究队列中，抑制的TSH水平与勃起功能障碍（ED）相关。校正混杂因素后，明显的甲状腺功能亢进症与严重勃起功能障碍的风险增加有关（在EMAS和UNIFI研究中，ED，危险比分别为14和16;均p <0.05）。这些关联在嵌套病例对照分析中得到了证实，将甲状腺功能亢进的受试者与年龄，BMI，吸烟状况和睾丸激素匹配的对照进行了比较。相反，未观察到原发性甲状腺功能减退症与ED之间的关联。总之，应该对所有甲亢患者进行勃起功能评估。相反，并非建议对所有ED患者进行常规的甲状腺功能评估。

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