Is There an Association Between Hypothyroidism and Sexual Dysfunction: A Systematic Review and Cumulative Analysis

INTRODUCTION: Many investigators have found a detrimental effect on sexual functioning developed by hypothyroidism in both sexes, but a cumulative analysis has not been conducted. AIM: This study aims to summarize and quantify the association between overt or subclinical hypothyroidism and the risk of sexual dysfunction (SD) through a meta-analysis. METHODS: 4 electronic databases were systematically searched. The quality of evidence was rated by the GRADE approach. This meta-analysis was registered on the PROSPERO (ID: CRD42020186967). MAIN OUTCOME MEASURE: The strength of the relationship between overt/subclinical hypothyroidism and SD was quantified by presenting the relative risk (RR) with its 95% confidence interval (CI). RESULTS: 7 studies involving 460 patients with hypothyroidism and 2,143 healthy controls were included in this meta-analysis. Among the 7 included studies, 2 studies were provided the data of both overt and subclinical hypothyroidism. Pooled results from 4 included studies investigating overt hypothyroidism indicated that overt hypothyroidism led to significant SD in both sexes (RR = 2.26, 95% CI: 1.42 to 3.62, P = 0.001), while synthetic RR of 5 eligible studies reporting subclinical hypothyroidism failed to find a positive association between subclinical hypothyroidism and SD (RR = 1.3, 95% CI: 0.85 to 1.99, P = 0.229), irrespective of gender (all P > 0.05). Subgroup analyses revealed that women with overt hypothyroidism rather than men with overt hypothyroidism were correlated with a significant higher risk of SD. The quality of evidence in the study of overt hypothyroidism and subclinical hypothyroidism was considered low and moderate, respectively. CONCLUSION: SD is a devastating problem in female patients with clinical hypothyroidism but insusceptible in either women or men with subclinical hypothyroidism. Clinicians should be aware of these phenomena and manage the sufferers accordingly in clinical practice. More rigorous studies are still needed to validate this evidence. Shen M, Li X, Wu W, et al. Is There an Association Between Hypothyroidism and Sexual Dysfunction: A Systematic Review and Cumulative Analysis. Sex Med 2021;9:100345.