ABSTRACT
The use of levothyroxine is not always related to the elimination of the symptoms of hypothyroidism. The aim of this study is to compare the health-related quality of life (HRQOL) of a group of hypothyroid women under levothyroxine treatment with that of a group of non-hypothyroid women. METHODOLOGY: A case-control study was performed. We used convenience sampling. The case group consisted of 152 levothyroxine-treated hypothyroid women; the control group consisted of 238 women without hypothyroidism disorders. All of the participants were euthyroid according to the clinical practice guidelines. We used as instruments the Short Form-12 questionnaire (SF-12v1) and a sociodemographic questionnaire. RESULTS: Hypothyroid women scored significantly lower in HRQOL in SF-12v1 mental and physical components than the control group (mental component summary: 41.23 ± 12.12 vs. 46.45 ± 10.22, p < 0.001; physical component summary: 49.64 ± 10.16 vs. 54.75 ± 5.76, p < 0.001). body mass index (BMI) and age showed an influence on the physical component (p < 0.001 in both variables). Adjusted for age and BMI, hypothyroidism was still related to worse scores (p < 0.001). CONCLUSION: Despite being euthyroid, women with hypothyroidism showed a poorer quality of life than women without hypothyroidism. Health professionals need to assess the HRQOL of women with hypothyroidism. Further research on HRQOL and hypothyroidism is needed.
ABSTRACT
Background: Levothyroxine is the most common treatment to normalize thyroid hormones levels and to reduce primary hypothyroidism symptoms. Aim: To assess sexual function in women with levothyroxine-treated hypothyroidism and women without hypothyroidism. Methods: A case-control study was performed with 152 women with levothyroxine-treated hypothyroidism and 238 women without hypothyroidism. An online survey was used to collect socio-demographic data and the answers to the Women Sexual Function (WSF) questionnaire. Results: Women with levothyroxine-treated hypothyroidism showed a higher prevalence of sexual dysfunction than women in the control group (31.60% vs. 16.40%), furthermore the presence of hypothyroidism increased the risk of sexual dysfunction (p = 0.002, OR: 2.29 (1.36-3.88)). The most affected domains were 'desire' (p < 0.001), 'arousal' (p = 0.003) and 'penetration pain' (p = 0.020). In hypothyroid women, age increased the risk of sexual dysfunctions (p = 0.009, OR: 1.07 (1.01-1.12)), however when age was adjusted (ANCOVA) the sexual dysfunction remained in women with hypothyroidism in all domains. Conclusions: Hypothyroidism is associated with an increase in the prevalence of sexual dysfunction even if treated with levothyroxine and thyroid-stimulating hormone (TSH) levels are normalized. Relevance to clinical practice: Sexual function in hypothyroid women should be assessed before and after starting the treatment.
Subject(s)
Hypothyroidism , Sexual Dysfunction, Physiological , Thyroid Hormones , Thyroxine , Adult , Case-Control Studies , Female , Humans , Hypothyroidism/drug therapy , Middle Aged , Sexual Dysfunction, Physiological/complications , Thyroid Hormones/therapeutic use , Thyrotropin , Thyroxine/therapeutic useABSTRACT
Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28-3.38) and depression (OR = 3.13, IC = 1.45-6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.
Subject(s)
Hypothyroidism/complications , Hypothyroidism/drug therapy , Mood Disorders/complications , Thyroxine/therapeutic use , Adult , Case-Control Studies , Female , Humans , Hypothyroidism/psychology , Prevalence , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To determine whether weather conditions explain the North-South gradient in multiple sclerosis (MS) mortality described in Spain. METHODS: The age-adjusted MS mortality rate by Spanish provinces from 1975 to 1998 was correlated with several climatic variables. RESULTS: MS mortality was negatively correlated with minimum, average and maximum temperatures, the mean number of hours of sunshine, and the mean number of sunny days. A positive correlation was found with the average amount of rain. Most correlations disappeared after adjusting by latitude. However, MS mortality was associated with latitude after adjusting by climatic factors. CONCLUSIONS: The North-South gradient in MS mortality in Spain cannot be fully explained by weather differences. Therefore, other hypotheses are required to explain this association.
Subject(s)
Meteorological Concepts , Multiple Sclerosis/mortality , Female , Humans , Male , Spain/epidemiologyABSTRACT
Objetivo: Comprobar si las variables meteorológicas justifican el gradiente norte-sur en la mortalidad por esclerosis múltiple (EM) en España. Métodos: La tasa de mortalidad por EM ajustada por edad en cada provincia de 1975 a 1998 se correlacionó con la media anual de diferentes variables meteorológicas. Resultados: Las temperaturas mínima, media y máxima, el número medio de horas de sol y el número de días soleados se correlacionaron negativamente con la mortalidad por EM, mientras que la cantidad de lluvia se correlacionó positivamente con la EM. La mayor parte de las correlaciones desaparecen al ajustar por latitud. En cambio, la mortalidad por EM está asociada con la latitud incluso después de ajustar por los factores meteorológicos. Conclusión: El gradiente norte-sur en la mortalidad por EM en España no puede explicarse completamente por factores meteorológicos. Son necesarias otras hipótesis para justicar esta asociación
Objectives: To determine whether weather conditions explain the North-South gradient in multiple sclerosis (MS) mortality described in Spain. Methods: The age-adjusted MS mortality rate by Spanish provinces from 1975 to 1998 was correlated with several climatic variables. Results: MS mortality was negatively correlated with minimum, average and maximum temperatures, the mean number of hours of sunshine, and the mean number of sunny days. A positive correlation was found with the average amount of rain. Most correlations disappeared after adjusting by latitude. However, MS mortality was associated with latitude after adjusting by climatic factors. Conclusions: The North-South gradient in MS mortality in Spain cannot be fully explained by weather differences. Therefore, other hypotheses are required to explain this association
Subject(s)
Humans , Climate Effects , Multiple Sclerosis/mortality , Climate Change , Seasons , Epidemiologic MethodsABSTRACT
Trends of multiple sclerosis mortality in Spain from 1951 to 1997 are examined. Age-adjusted mortality strongly decreased from 3.08 per 100,000 women in 1951-1967 to 0.59 in 1968-1980 (similar figures were obtained for men). This decrease seems to be due to an artifact produced by changes in codification of causes of death. An age-period-cohort analysis, limited to the period 1968-1997, showed that the mortality trend in Spain cannot be fully explained by year of death (period effect), but that a cohort (year of birth) effect is also necessary. An increase in mortality related with the cohort of birth was detected: people born after 1953 had double the risk of those born between 1938 and 1947, and four times the risk of those born between 1923 and 1932. Regarding the period effect, there is a decrease in mortality, probably due to improvements in life expectancy of multiple sclerosis patients.
