Thyroid diseases are observed quite frequently in our society, especially during the reproductive age. As a reflection of this, the relationship between complaints such as menstrual irregularity and decreased fertility in women and thyroid diseases is wondered.
In fact, studies have shown that some thyroid diseases cause problems related to menstrual irregularity and infertility in women. I would like to examine the subject under a few headings.
Hypothyroidism, The most important causes of hypothyroidism, which is characterized by high TSH hormone and low free T4 hormone, are Hashimoto's disease and iodine deficiency. In both cases, TSH increases. As a result, menstrual irregularities may be detected in women. Hashimoto's disease occurs when antibodies against the thyroid gland damage the thyroid gland. These antibodies are Anti-TPO and Anti-Tg. A normal pregnancy can be achieved by giving thyroid hormone treatment to people with Hashimoto's disease. However, if treatment is not given, it may cause miscarriage even if pregnancy occurs. Therefore, young women planning pregnancy should take regular medications if they have these diseases, and their thyroid hormone levels should be monitored regularly, especially before and during pregnancy, to ensure that they are within the desired range.
Iodine deficiency is still important in our society. It is a health problem. If severe, thyroid functions may deteriorate and lead to hypothyroidism. In this case, menstrual irregularities and problems with pregnancy may occur. All pregnant women planning pregnancy should definitely eat a diet rich in iodine. In terms of iodine deficiency, the degree of deficiency can be determined by looking at the iodine level in the urine. If iodine deficiency is not treated during pregnancy, a condition called cretinism that causes mental retardation and developmental delay may be observed in children. Therefore, it is very important to have a diet rich in iodine before and during pregnancy.
Hyperthyroidism is a disease characterized by low TSH and high free T4. It may occur due to many different reasons. Graves' disease and toxic multinodular goiter are the most common causes. Low TSH may cause infertility in women as there may be disorders in the menstrual cycle such as prolongation of menstrual periods, menstrual irregularity, and cessation of menstruation. You may have difficulty getting pregnant suddenly. However, after treatment, the clinical condition quickly improves and menstruation returns to normal. Low TSH seen at the beginning of pregnancy is a physiological change seen in pregnant women. This situation requires special follow-up.
Thyroid nodules, alone do not cause infertility in women unless they disrupt thyroid functions. However, thyroid nodules can become active over time and start producing thyroid hormone. In this case, it can lead to hyperthyroidism in women, as we mentioned before.
Recurrent miscarriages may occur in some patients who are anti-TPO positive and whose TSH and free T4 levels are within normal limits. It may be necessary to give treatment to these people even if their TSH is below 2.5. These patients are considered to have euthyroid Hashimoto's disease. Research has shown that women in such patients have difficulties in getting pregnant.
As a result, it is necessary to check the thyroid functions and thyroid autoantibodies in all women who have recurrent miscarriages, menstrual irregularities and difficulties in getting pregnant. Once the diagnosis is made and the treatment is started, if there are no other problems, pregnancy will occur in a short time.
I wish you healthy days.
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