Background:
Hormonal imbalances have been associated with various sexual dysfunction disorders. In particular, hyperthyroidism has been found to correlate to premature ejaculation (PE) and persistent genital arousal disorder (PGAD).

Aim:
To review the literature regarding hyperthyroidism effects on sexual dysfunction, with a focus on hyperthyroidism and PE and PGAD.

Methods:
A comprehensive review of PubMed articles and clinical studies was performed using keywords “hyperthyroidism” and/or “premature ejaculation” and/or “persistent gonadal arousal disorder” and/or “sexual dysfunction” and/or “dopamine genital hypersensitivity.”

Main Outcome:
The symptoms, classification, pathophysiology, diagnostic considerations, and physiological mechanism of hyperthyroidism on PE and PGAD were reviewed. This review describes the evaluation, clinical presentation, and mechanism of treatment for patients presenting with PE and PGAD with hyperthyroidism.

Results:
A connection between thyroid-produced hormones (TH) and dopamine levels could be linked to PE and PGAD, as increased dopamine levels can lead to a hypersensitive genital area. Studies have demonstrated a plausible hormonal connection between TH as 7-hydroxy-2-(di-N-propylamino) tetralin (7-OH-DPAT), showing the effect of brain oxytocin receptors mediating ejaculation. Multiple case studies have reported that dopamine antagonists decrease hypersensitivity in the genital region.

Conclusion:
The effect of thyroid dysfunction on sexual dysfunction needs to be further investigated, especially with a emphasis on the physiological mechanisms involved with thyroid hormones and dopamine.

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Learning Objectives:
Learners should be prepared to gain an understanding of how disorders such as premature ejaculation and persistent genital arousal disorder maybe connected to hyperthyroidism. These disorders are distressing for people, preventing them from seeking normal relationships and/or sexual encounters. Additionally, this presentation will emphasize the importance of thyroid function and how it should be included in the sexual dysfunction evaluation, as symptoms of premature ejaculation and persistent genital arousal disorder can be a result of the thyroid hormone effect on dopamine. Finally, it will cover the possible treatment of premature ejaculation with dopamine antagonist.