CLINICAL THYROIDOLOGY FOR THE PUBLIC
A publication of the American Thyroid Association

Summaries for the Public from recent articles in Clinical Thyroidology

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THYROID DISORDERS
Thyroid disorders and impairment in sex life

CTFP Volume 12 Issue 4

BACKGROUND
Thyroid disorders (hypothyroidism, hypothyroidism, thyroid cancer) have been linked to a reduced quality of life in some clinical studies. Even fewer studies have looked at the effect of thyroid disorders on sexual function. To date, a few small studies have reported impaired sexual function in women with thyroid problems and in individuals with Hashimoto’s thyroiditis. Only a single small study has examined the effect of nodular goiter on sexual function. This study examined how common impaired sex life was noted in a survey of patients with thyroid disorders.

THE FULL ARTICLE TITLE:
Sawicka-Gutaj N et al 2018 Patients with benign thyroid diseases experience an impaired sex life. Thyroid. Epub; Jul 24

SUMMARY OF THE STUDY
This study was done in Denmark. The study included 877 patients with thyroid diseases who were recruited from two Danish university outpatient clinics in 2007–2008 as well as another 432 patients with newly diagnosed thyroid disorders recruited at the same clinics between 2008 and 2012 and followed for 6 months. Patients with thyroid nodules, hyperthyroidism, Graves’ disease and autoimmune thyroid disease were included. Serum thyroid hormone levels were measured at baseline and were repeated at in those patients followed for 6 months. The Thyroid-Related Patient-Reported Outcome questionnaire (ThyPRO) and the general 36-Item Short Form Health Status Survey were done to understand the effect of these diseases on patients’ sex life. The ThyPRO questionnaire included the question “During the past 4 weeks, have you felt your thyroid disease had a negative impact on your sex life?” The five response levels ranged from “not at all” to “very much.”

The average ages of men and women in the study ranged from 51-56 years. The average duration of thyroid disease in the cross-sectional sample was 29 months in women and 15 months in men. A total of 29-34% of the men and women in the different samples had nontoxic goiter, 16-26% had toxic nodular goiter, 15-22% had Graves’ disease without eye disease, 8-11% had Graves’ with eye disease and 12-23% had Hashimoto’s hypothyroidism. Results showed that 36-42% of women and 31-33% of men reported impairments in their sex life. In women, nodular goiter was less likely to be associated with sex life impairment than autoimmune thyroid diseases. In addition, there was a link between how high the T3 hormone level was and the effect on sexual function in patients with Graves’ disease.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
The authors concluded that based on the results of this study, ~40% of patients with thyroid disorders also note impairment of their sex life. This was slightly more common in women. This study shows that the effect of treatment of thyroid diseases on quality of life and sexual function also needs to be studies in more detail. It also brings awareness of this issue to physicians and indicates this area should be addressed with their patients.

— Vibhavasu Sharma, MD, FACE

ABBREVIATIONS & DEFINITIONS

support thyroid researchThyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. While most thyroid nodules are non-cancerous (Benign), ~5% are cancerous.

Autoimmune thyroid disease: a group of disorders that are caused by antibodies that get confused and attack the thyroid. These antibodies can either turn on the thyroid (Graves’ disease, hyperthyroidism) or turn it off (Hashimoto’s thyroiditis, hypothyroidism).

Hashimotos thyroiditis: the most common cause of hypothyroidism in the United States. It is caused by antibodies that attack the thyroid and destroy it.

Goiter: a thyroid gland that is enlarged for any reason is called a goiter. A goiter can be seen when the thyroid is overactive, underactive or functioning normally. If there are nodules in the goiter it is called a nodular goiter; if there is more than one nodule it is called a multinodular goiter.

Graves’ disease: the most common cause of hyperthyroidism in the United States. It is caused by antibodies that attack the thyroid and turn it on.

Toxic nodular goiter: characterized by one or more nodules or lumps in the thyroid that may gradually grow and increase their activity so that the total output of thyroid hormone in the blood is greater than normal.

Triiodothyronine (T3): the active thyroid hormone, usually produced from thyroxine.

Thyroid-Related Patient-Reported Outcome questionnaire (ThyPRO): a validated questionnaire in determining quality of life in patients with thyroid disorders