Sexual function and depressive symptoms in young men with hypothyroidism receiving levothyroxine/liothyronine combination therapy

Introduction: Both overt and subclinical hypothyroidism are often accompanied by sexual dysfunction. Despite improving male sexual functioning, levothyroxine treatment does not always restore all its aspects. The aim of this study was to compare male sexual function­ing and depressive symptoms between men with hypothyroidism receiving levothyroxine/liothyronine combination therapy and men receiving levothyroxine alone. Material and methods: The study population consisted of 21 young levothyroxine-treated men with clinical symptoms of hypothyroid­ism, in whom serum thyrotropin and thyroid hormone levels were within the normal limits. In 11 of these patients, levothyroxine was replaced with levothyroxine/liothyronine combination therapy, while the remaining ones (n = 10) continued levothyroxine treatment. Beyond measuring serum levels of thyrotropin, free thyroxine, free triiodothyronine, and prolactin, before the beginning of the study and six months later, all enrolled patients completed questionnaires evaluating male sexual function (International Index of Erectile Func­tion-15: IIEF-15) and assessing the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition — BDI-II). Results: The study included 10 patients from each group. At baseline, erectile function, intercourse satisfaction, orgasmic function, sexual desire and overall satisfaction, as well as the total BDI-II score did not differ between both groups. With the exception of an improvement in sexual desire, replacing levothyroxine with levothyroxine/liothyronine combination therapy did not affect sexual functioning and depressive symptoms. Conclusions: The obtained results suggest that levothyroxine/liothyronine combination therapy has a relatively mild effect on sexual functioning in levothyroxine-treated men with normal thyrotropin and thyroid hormone levels experiencing clinical symptoms of hypo­thyroidism.