Reviewer ’s report  
 
Title: Subclinical Hypothyroidism Would Not Lead To Female Sexual Dysfunction in Chinese 
Women  
 
Version: 0 Date: 28 Dec 2016  
 
Reviewer: Daniela Pasquali  
 
Reviewer's report:  
 
Comments to Author  
1. 1119 participants were recruited to evaluate the relationship between subclinical 
hypothyroidism (ScH t ) and sexual dysfunction in Chinese women. Risk factors of FSD 
were identified. CVFSFI>23.45 was the value to identify sexual dysfunction. The authors 
did not find significant differences between women with ScHt and controls. This is an 
original report b ut I have some concerns about the study design that could affect the results.  
2. ScHt participants and 951 controls. In this case control study there are important numerical 
differences between ScHT (n168) and controls (n 951). I have some doubt about poss ible 
bias linked to this discrepancy.  
3. In this hospital based research was the control population affected by diseases that can affect 
the research results other than subclinical hypothyroidism?  
4. In table 1 TSH and AbTPO values in ScHt group were 5.4(4 .7, 6.5) mU/L and 9.0(5.2, 41.5) 
respectively. Surprisingly, this data demonstrated that ScHt was not related to Hashimoto's 
thyroiditis, the most common thyroidal cause of SCHt in adults.  How can the authors 
explain this very uncommon data?  
5. The diagn osis of ScHt requires the repetition of TSH value at least one more time to confirm 
this condition. Do the authors confirm the TSH data? If not, I have some concern 
considering the ScHt group really affected by thyroid disease. The results do not support t he 
conclusions.  
6. In the discussion section the authors affirm:  To our limited knowledge, it is the first study to 
explore the relationship between thyroid hormone and female sexual dysfunction (FSD).  
This sentence is incorrect, several reports have stud ied the relationship between thyroid function 
and FSD (i.e. Clin Endocrinol (Oxf). 2016 Jun;84(6):925 -31. doi: 10.1111/cen.12956. Epub 2015 
Oct 19.Sexual function and depressive symptoms in young women with thyroid autoimmunity 
and subclinical hypothyroidi sm.Krysiak R1, Drosdzol -Cop A2, Skrzypulec -Plinta V2, Okopien 
B1) and the authors also reported in the references some of the literature data (Pasquali D et al ) 
and some of them are discussed (Atis G et al)  
 
Minor points  
- English form should be evaluated.  
- References sometimes are not appropriate.  
Are the methods appropriate and well described?  
If not, please specify what i s required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, p lease explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects  require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose fin ancially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do y ou hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
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