Thyroid Homoeostasis and Reproductive Hormonal Disorders in Women

А.А. Yunusov

Abstract


Objective of the study — to investigate the influence of hypo- and hyperthyroidism on the state of reproductive function for women and to estimate efficiency of treatment. Material and Methods. 156 women of reproductive age are examined concerning inflammatory gynaecological and endocrine disorders. Complex of laboratory and clinical investigations included: anamnesis, examination; unified clinical and biochemical methods of research; studying research hormones in blood plasma (thyroid stimulating hormone, prolactine, Т3, Т4, fТ4, antibodies to thyroglobulin, thyroid peroxidase; luteinizing hormone, follicle-stimulating hormone (FSH), estradiol, progesteron, testosteron); ultrasonic examination of thyroid gland, mammary gland, pelvic organs; radiography of sella turcica; fine needle biopsy of the thyroid. Results. The comparative analysis of different pathologies of reproductive function in both clinical groups showed, that infertility, both primary and secondary, prevailed in the group with hypothyroidism — 66 vs 33.3 % in the group of women with hyperthyroidism. In the first clinical group, signs of menstrual disorders (68.2 %), galactorrhea (63.6 %), breast pathology (55 %) also prevailed, while in the second group these indexes were 38.8, 22.2 and 33.3 %, respectively. In the structure of menstrual disorders, oligomenorrhea prevailed in both clinical groups — 47 and 57 %. Most women (76.9 %) had I degree of galactorrhea and bilateral galactorrhea (80.7 %). Cervical pathology was detected 45 % of women, with predominance of pseudoerosion (55.5 %), and in 12.5% — hysteromyoma. Chronic salpingo-oophoritis was diagnosed in 47.5 % of patients, cystic ovaries — in 10 % of women of clinical group. Conclusions. Thyroid pathology in women of reproductive age is characterized by autoimmune thyroiditis (24.3 %), diffuse toxic goiter (10.8 %) and nodular goiter (16.2 %). Women with thyroid hormone deficit have a decline of gonadotropic pituitary function with development of hyperprolactinemia, reduced steroidogenesis, luteal-phase defect. At hyperthyroidism women have hyperestrogenism that by feedback mechanism results in the decline of FSH concentration. The progesterone level remains low due to reduction of sensitivity of ovarian tissue to luteinizing hormone under FSH deficiency.


Keywords


thyroid gland; reproductive system; hormonal disorders

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DOI: https://doi.org/10.22141/2224-0721.8.64.2014.77873

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