THYROID AND WOMEN

A good thyroid functioning is fundamental during all life stages especially in women. Though we still do not know exactly why, it is well known that women are more likely to suffer from both functional and morphological thyroid disorders. For instance, in case of Hashimoto’s thyroiditis, commonly associated with hypothyroidism, the percentage of inflammation development is 7% in women, against 1.3% in men.
Given the close relationship between fertility and thyroid functioning, women should keep the balance as efficient as possible. It is well known that the thyroid hormones activity is strictly connected to estrogens. The more estrogens are produced, the less thyroid hormones are able to carry out their functions.
We can see how a thyroid altered activity affects girls’ fertility, since adolescence. Actually hypothyroidism is often associated with amenorrhea and sexual functioning alterations in these patients.

Thyroid and fertility

Given the strict relationship, several endocrinological associations have considered essential to establish some guidelines to deal with thyroid in the women who are trying to get pregnant. In the new guidelines published by ATA in 2017, keeping TSH below 2.5 mUI/L is considered essential for the women who wish to have a baby. That is why it is recommended to check thyroid functioning in these women as well as to adjust any alteration in order to optimally achieve the goal. Both in women who find out such alterations while they are trying to get pregnant, and in those who are already aware of the problem.
Taking supplements to bring TSH values back to normal could turn useful to the formers, whereas reviewing levothyroxine posology is often essential to the latters.

Thyroid and menopause

Menopause is one of women’s life stages endocrinologists should pay more attention to. Infact, the body under goes changes affecting thyroid functioning. As said, estrogens play an important role by checking thyroid hormones (fT3 and fT4) activity, increasing the quantity of the protein which ties together such hormones and prevents them to carry out their functions. The quantity of estrogens decreases in menopause and consequently the quantity of active thyroid hormones circulating in the body increases. Therefore, an improvement of hypothyroidism is possible.
That is why the general condition of menopause women suffering from subclinical hypothyroidism is often reconsidered, and therapy can undergo variations or, in some cases, be suspended. Moreover, we should not underestimate that menopause causes an increasing risk for bones possibly associated with the one generated by the treatment, therefore worsening the patient’s condition.