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Thyroid disease and female reproduction

Thyroid disease and female reproduction,10.1016/S0015-0282(00)01589-2,Fertility and Sterility,Gerasimos E Krassas

Thyroid disease and female reproduction   (Citations: 62)
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Objective: To review the menstrual function and fertility in thyroid disease, mainly in hyperthyroidism and hypothyroidism. Also to register the consequences of 131I therapy, which is used widely in the treatment of Graves’ disease and thyroid cancer, on subsequent pregnancies and on fertility in these patients.Design: A MEDLINE computer search was used to identify relevant studies. The type of menstrual disturbances and the status of fertility were recorded from all the studies found. Also, the fertility and genetic hazard of female patients with Graves’ disease and thyroid cancer who were treated with 131I were registered.Result(s): Both hyperthyroidism and hypothyroidism may result in menstrual disturbances. Menstrual abnormalities are less common now than in previous series. In a recent study, we found that only 21.5% of 214 thyrotoxic patients had some type of menstrual disturbance, compared to 50 to 60% in some older series. The most common manifestations are hypomenorrhea and oligomenorrhea. According to the results of endometrial biopsies, most thyrotoxic women remain ovulatory. Moreover, the genetic hazard incident to radioiodine therapy in Graves’ disease and thyroid carcinoma is very small; exposure to 131I does not cause reduced fecundity, and the risk of loss of fertility is not a contraindication for its use in these patients. mIn hypothyroidism, the frequency of menstrual irregularities has very recently been reported to be 23.4% among 171 hypothyroid patients studied. This is much less than that reported in previous studies, which showed that 50 to 70% of hypothyroid female patients had menstrual abnormalities. The most common manifestation is oligomenorrhea. Severe hypothyroidism is commonly associated with failure of ovulation. Ovulation and conception can occur in mild hypothyroidism. These pregnancies are, however, often associated with abortions, stillbirths, or prematurity. The latter may be of greater clinical importance in infertile women with unexplained infertility.Conclusion(s): These new data, mainly concerning menstrual abnormalities in hyperthyroidism and hypothyroidism, are inconsistent with what is generally believed and written in the classic thyroid textbooks and indicate that such opinions should be revised.
Journal: Fertility and Sterility - FERT STERIL , vol. 74, no. 6, pp. 1063-1070, 2000
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    • ...A substantial part of hypothyroidism in women during pregnancy is also caused by the autoimmune thyroid disease [14, 15]...

    Viola Vargováet al. Maternal autoimmune thyroiditis and congenital malformations of newbor...

    • ... Isolated TAI has also been associated with an increased rate of miscarriage, mainly in the first trimester...

    Brigitte Velkenierset al. The role of thyroid autoimmunity in fertility and pregnancy

    • ...Both hyper- and hypothyroidism may lead to irregularity of the menstrual cycle, premature or delayed sexual development, disturbances in levels of luteinizing hormone, prolactin, and sex hormones binding globulines [3]...
    • ...However, the interaction between thyroid function and selenium should be seen in the broader context of other concomitant endocrine factors, as growing corpus of data strongly indicates the existence of relationships also between gonadal function and selenium status [1, 2] and between gonadal function and thyroid function [3, 21]...
    • ...The finding implies rather that apart from “classical” factors, e.g., iodine intake, the female reproductive system may also affectthyroid metabolism, which is in line with many other observations [3]...

    Paweł Zagrodzkiet al. The Interaction Between Selenium Status, Sex Hormones, and Thyroid Met...

    • ...Conditions that disrupt thyroid hormones in women, such as hypothyroidism and hyperthyroidism, are associated with short and long cycles, amenorrhea, anovulation, and infertility (45, 46)...

    S. L. Farret al. Pesticide Use and Menstrual Cycle Characteristics Among Premenopausal ...

    • ...Chemotherapeutic agents have been shown to cause fibrotic changes and follicular destruction in the ovaries and pre- and peri-menopausal women have been observed to have reduced serum estradiol levels during chemotherapy [27, 28, 33]...
    • ...Variations in basal metabolic rate (BMR) of up to 6–10% have also been reported to occur during the course of the menstrual cycle [47, 67] possibly secondary to changes in the endocrine state [27, 28]...

    Nagi Kumaret al. Fatigue, Weight Gain, Lethargy and Amenorrhea in Breast Cancer Patient...

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