Originally Posted May 2017
Updated May 2019
The month of May contains both Mother’s Day and Women’s Health Week, both of which give us the opportunity to examine the influence of a frequently overlooked component of women’s health; the thyroid. This small gland located in the neck has an impressive level of influence over bodily function. Because the thyroid is responsible for numerous hormones that influence nearly every area of the body, malfunction or disease affecting this critical system can cause widespread disruption.
Many are familiar with the common symptoms of thyroid disease, including fatigue, notable weight gain or loss, and poor cognitive function, regrettably there are others that are often overlooked. Women with thyroid disease or dysfunction may experience more impactful symptoms such as menstrual difficulties, infertility and miscarriage – get a full list of thyroid disease symptoms here.
It is estimated that millions of women are living with an undiagnosed or untreated thyroid condition that is contributing to these frustrating and difficult symptoms. The thyroid is one of the most influential systems in the body and is therefore important to consider when discussing women’s health. Properly caring for this small gland is an important part of improving women’s health.
Thyroid Disease and Women’s Health
Of the many systems affected by the thyroid, fertility and reproductive function may be the least acknowledged. Although many are aware that hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) negatively influence hormone balance, metabolism, and mental function, they may not recognize the impact of these conditions on female-specific processes.
There are numerous menstrual difficulties associated with both hypothyroidism and hyperthyroidism. Although both conditions influence the menstrual cycle, hypothyroidism is a more common contributor to irregularities and issues.
Underactive thyroid function can have a number of effects on menstruation. Perhaps the most recognized symptoms is
experience increased menstrual bleeding, known as menorrhagia. This can be recognized through excess flow that causes soaking through a pad or tampon at an hourly rate for multiple consecutive hours. An increase of flow to this degree may cause extreme fatigue and shortness of breath, suggesting anemia or heavy blood loss. Furthermore, the duration of the menses may extend to a full seven days.
Additionally, can cause both increased frequency and absent or infrequent menstruation – absent or infrequent menses are more common. The infrequency is caused by an increase in thyroid releasing hormone (TRH) which trigger the release of prolactin, a hormone that interferes with the production of estrogen.
A condition known as dysmenorrhea (menstrual cramps) may also be exacerbated by an underactive thyroid. Those suffering from PMS frequently report symptoms that are consistent with this condition. Common symptoms associated with dysmenorrhea include:
- Lower back pain
- Muscle aching and weakness
- Irregular bowel function
- Severe cramping
About one out of ten women experience this condition and it is more often found among thyroid patients. Dysmenorrhea shares some symptoms with endometriosis and is often misdiagnosed as such. To properly treat dysmenorrhea thyroid function should be optimized through hormone replacement therapy.
On the other end of the thyroid spectrum is hyperthyroidism with commonly results in absent or infrequent menses due to an increase sex hormone-binding globulin (SHBG) which can prevent ovulation. When menstruation does occur, it tends to be lighter.
Additionally, girls with overactive thyroids may not go through puberty or experience their first menstrual cycle until after the age of 15.
Hormone balance, particularly progesterone and estrogen, is a critical element in the reproductive cycle. These two hormones are classified as the female sex hormones and are necessary for healthy conception. Thyroid disease may inhibit a woman’s ability to regulate these hormones, making regular ovulation difficult. Without reliable ovulation, the time span where conception is possible and/or optimal can become difficult to track. Furthermore, the window of opportunity may be completely shut if the thyroid condition is severe.
Thyroid conditions may also promote the development of ovarian cysts that can negatively impact the ability to become pregnant. These small polyps or nodules can store hormones that promote further imbalances, therefore altering reproductive function.
Experiencing a miscarriage can be the most tragic event in a woman’s life. Unfortunately, untreated and undiagnosed thyroid conditions may contribute to many of these experiences. According to Dr. Hugh D. Melnick, Medical Director of Advanced Fertility Services in New York City, an impressive number of miscarriages and cases of infertility are caused by thyroid malfunction. The truly sad part of this situation is that many who would benefit from thyroid treatment and supplementation are simply not being diagnosed. In Melnick’s extensive experience in treating infertility among women, he has found that women who exhibit common signs of thyroid dysfunction (fatigue, depression, irregular periods, low libido, weight gain) have an improved rate of conception and reduced incidence of miscarriage when treated with optimized thyroid supplementation. This may seem like an obvious connection but many do not receive this seemingly simple treatment.
It is a common occurrence for doctors to attribute otherwise unexplained miscarriage and infertility on physical, emotional, or psychological stress. Regrettably, many overlook the possibility that their patient has a thyroid disease or dysfunction. This is unfortunate as, according to some surveys, up to 30% of women have a thyroid condition.
Women’s Health Includes Thyroid Health
If you have or are currently experiencing the difficulties of irregular menstruation, infertility, and miscarriage it is prudent to examine the possibility of a thyroid condition. Getting diagnosed and properly treated is the only way to fully resolve thyroid dysfunction. Optimization of the thyroid may also resolve reproductive difficulties and hormonal imbalances that cause undue stress, pain, and weariness. Even if you have been treated for thyroid malfunction for an extended time, your needs may have changed. Minor improvements and greater optimization may be all that is needed to resolve associated conditions.
Being fully aware of the impact of the thyroid and providing the care it needs to thrive gives one the opportunity to improve not only their body but their quality of life as well.
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2. Kakuno Y et al. “Menstrual disturbances in various thyroid diseases.” Endocr J. 2010;57(12):1017-22.
3. Saran S et al. “Effect of hypothyroidism on female reproductive hormones.” Indian J Endocrinol Metab. 2016 Jan-Feb; 20(1):108-13.
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