Abstract 84: Study of sex hormone levels and sexual dysfunction in primary hypothyroidism

Background: Thyroid hormone deficiency may present with overt clinical symptoms or may have mild or no manifestations. Even in patients with overt biochemical hypothyroidism, symptoms and signs may be minimal or absent, especially in older persons. There is paucity of data in our country on serum levels of total testosterone, estradiol in primary hypothyroidism. The present study was done to assess sex hormone profile and sexual dysfunction, if any, in subjects with primary hypothyroidism. The study was done to measure serum levels of total testosterone in males and estradiol in females with primary hypothyroidism (overt and subclinical) and assess sexual function (erectile dysfunction in males and sexual arousal disorder in females) in the form of a questionnaire. Methods: This study was conducted in Endocrinology OPD of a superspeciality centre in south India in subjects with primary hypothyroidism. A detailed history was taken, and a physical examination of participants was done. Anthropometric parameters like height, weight, and BMI were measured. Information regarding their sexual activity during the past four weeks was noted and the questionnaire was given to participants up to the age of 60 years. The questionnaires used were the female sexual function index for females and the international index of erectile function for males. Results: A total of 49 subjects with newly diagnosed primary (subclinical and overt) hypothyroidism which included 37 females with TSH 16.34 ± 16.95 mIU/ml, estradiol 59.74 ± 51.84 pg/ml and FSFI score 24.1 ± 3.43 and 12 males with TSH 21.8 ± 15.7 mIU/ml, testosterone 399.67 ± 145.03 ng/dl and IIEF score 44.0 ± 9.802. Thirty seven percent of females and sixteen percent of males had subclinical hypothyroidism. Sexual dysfunction was present in 23 out of 37 females (62%) and 3 out of 12 (25%) males, and all three men had a low score in the erectile function domain of IIEF. The arousal domain was the most affected (68.7% scored less than 4), and satisfaction was least affected (28.6% scored less than 4) in females. Thyrotropin values didn't show correlation with T in males and E2 in females. FSFI and IIEF scores did not correlate with TSH values. Conclusion: The prevalence of sexual dysfunction in primary hypothyroidism was higher in females than males. The most affected domain was arousal in females and erectile function in males. Around thirty-seven percent of females in this study had subclinical hypothyroidism, and a higher prevalence of sexual dysfunction in females may be an indication to treat these patients with levothyroxine.