The Association Between Erectile Dysfunction and Subclinical Hypothyroidism in Males with Type 2 Diabetes Mellitus

Abstract
Aim: Overt hypothyroidism is known to affect sexual functions, but data on subclinical hypothyroidism (SCH) are insufficient. We aimed to investigate the relationship between erectile dysfunction (ED) and SCH in men with type 2 Diabetes Mellitus. Methods: This cross-sectional study included 117 diabetic patients aged between 45-70 years who applied to our outpatient clinic between March and June 2018. Biochemical blood tests and levels of hormones were analyzed. International erectile function index-5 (IIEF-5) questionnaire was applied for the assessment of ED. According to the IIEF-5 questionnaire scores, patients were grouped as severe ED (n=47), moderate ED (n=46), and no ED (n=24). Patients were also grouped according to the level of thyroid-stimulating hormone (TSH) into 3 groups; 0.27-2.49 mU/l (n=58), 2.5-4.2 mU/l (n=33), and >4.2 mU/l (n=26). Statistically significance level was set at 0.05. Results: 40% of the patients had severe ED and 39% moderate ED, while 21% had no ED. The TSH levels were significantly different between the ED groups (p<0.001). A significant negative correlation was found between the IIEF-5 score and the TSH levels (p<0.001, r=-0.453). The IIEF-5 score, and duration of ED were significantly different between the TSH groups (both; p<0.001). Conclusions: SCH is closely associated with ED in diabetic men. So, we recommend conducting thyroid function tests in diabetic men with ED and screening for ED in men with SCH.