MS (Obstetrics & Gynaecology)

Senior Consultant HEC PARAS HOSPITAL, Ranchi

Ex. Senior Resident Safdarjung Hospital, Delhi

Laparoscopy & InfertilitySpecialist

Thyroid Disorders and Implications in Females

Thyroid Disorders and Implications in Females

Written by :
Dr. Anshu Agarwal
MS (Obstetrics and Gynecology)
Fellowship in Laparoscopic Gyane Surgery.
Senior Consultant HEC Paras Hospital, Ranchi.

  • Introduction :

    • Thyroid disorders affect the thyroid gland: a butterfly shaped gland in front of the neck. Thyroid gland palys a important role of regulating numerous metabolic processes in the body, which decides how fast you burn your calories and how fast will your heart beats.
    • Thyroid gland uses Iodine to produce the important hormones like thyroxine(T4).
    • Functions of the thyroid gland is regulated by the feedback mechanism from the brain. When the thyroid hormone levels are low in the body, brain stimulates thyroid gland to produce more hormones in the body.
    • So any disorder of the brain(hypothalamus or pituitary) or thyroid gland itself can cause thyroid problems
    • Women are more commonly affected by thyroid disease than men. It is more in women's just after pregnancy and and after menopause.
  • Thyroid gland problems can be broadly divided into two categories:

    1. When the production of the thyroid hormone is more than normal (Hyperthyroidism).

    2. When the production of the thyroid hormone is less than normal (Hypothyroidism).

    In this article I will be discussing only about Hypothyroidism and its affect in females.
  • Hypothyroidism
    • This is a condition results from inadequate production of the Thyroid hormone due to any cause.
    • Common causes of hypothyroidism:

      1. Idiopathic (excat cause can't be found)

      2. Hashimoto's disease: Autoimmune disease in which immune system attacks and destroys body's own structures as thyroid gland.

      3. Hyperthyroidism over treatment

      4. Radiation treatment for some cancers

      5. Thyroid removal surgery

      6. Foods

    • Common symptoms of hypothyroidism are:

      1. Fatigue

      2. Poor concentration

      3. Dry skin

      4. Less sweating

      5. Thinning and dryness of hairs

      6. Constipation

      7. Cold Intolerance/ feeling cold

      8. Fluid retention

      9. Weight gain

      10. Puffy face

      11. Muscles and joints pain

      12. Hoarse voice

      13. Depression

      14. Prolonged or excessive menstrual bleeding in women

      15. Their is also associated high Cholesterol thus increased risk of heart disease.

  • How Thyroid gland problems affect women
    • As I told before, women are more likely to be affected by thyroid problems than men.
    • Around 10%-12% women are affected by thyroid disease in their lifetime
    • In women thyroid disorders can cause
    • 1. Irregular , heavy or missed periods:

      2. INFERTILITY: Anovulation (no release of egg from ovaries) which causes difficulty in being pregnant

      3. Thyroid disease in pregnancy:

      This can affect health of mother and baby as well, so early diagnosis and management of thyroid abnormality is a must in pregnancy.

  • Hypothyroidism Treatment:
    • Permanent hypothyroidism commonly caused by Hashimoto's disease, which requires life long treatment.
    • Reversible causes requires only short treatment as:

      1. Postpartum Thyroiditis - 70% corrects in one year

      2. Subacute Thyroiditis- Usually get corrected by short trem treatment

      3. Iodine Induced

      4. Drug Induced

      5. Post Ablative: post surgery or post radioactive Iodine therapy

    • Normal level should be maintained between 0.5 - 2.5 mIU/ L during replacement therapy.
    • Higher dosage of thyroid hormone drug are required in pregnancy
    • Follow up clinical and biochemical (blood test) should be done every 6-12 months
    • Treatment should be started with low dosage i.e 25-50 microgram in elderly and cardiac patients
    • Raised TSH inspite of treatment may be because of

      1. Noncompliance

      2. Inadequate dose i.e low dosage

      3. Reduced absorption of drugs

      4. Pregnancy