A variety of endocrine disorders can complicate pregnancy and vice versa. The most common of these are diabetes and thyroid disorder. Women usually face a number of endocrine issues due to the a number of changes that happen in their life. The cycle of menarche, pregnancy, middle age and menopause itself can illustrate the number of hormonal changes that a woman’s body undergoes. Hence it is obvious that woman need to care about their health more and deal with their complications without ignoring them. All forms of thyroid diseases are 4 to 5 times more common in females than in males. And these disorders interfere with the physiology of reproduction, menstrual function and fertility.
Thyroid issues in women:
Thyroid disease is common in the general population, and especially in young reproductive age females.
The normal thyroid gland is able to compensate for the increase in thyroid hormone demands. Active secretion of thyroid hormone by fetal thyroid gland commences at about 18 weeks gestation, although transfer of thyroxine from mother to embryo occurs from early pregnancy. Serum TSH is one of the most sensitive tools in the diagnosis of thyroid disorders. Hence to detect if there is any abnormality in the thyroid levels, doctors usually prescribe a TSH check.
TSH levels are also subject to circadian variation, rising several hours before the onset of sleep, and reaching peak levels between 11pm and 6am. Nadir concentrations are observed during the afternoon hence, measuring TSH levels at the same time of the day is recommended.
Thyroid issues are basically of two types- one in which there is a decrease in the production of thyroid (Hypothyroidism) and one in which there is an increased production – Hyperthyroidism .Hypothyroidism is associated with an increased risk of pregnancy induced hypertension. The incidence of postpartum depression may also be increased in these patients.
Issues caused due to thyroid issues :
Women with infertility should be screened for thyroid dysfunction, especially when endometriosis or ovarian dysfunction is the cause of infertility.Hypothyroidism during pregnancy is avoided, as it is associated with increased morbidly and a poorer outcome of pregnancy both for the mother and baby.
- Contraception: The non hormonal contraceptives methods like IUCD, barrier methods etc. do not influence the thyroid status.
- Administration of oral contraceptive pills does not change the free thyroxine levels . Hence, these agents do not significantly alter the thyroid status.
- Routine screening of thyroid abnormalities is recommended and treatment of sub clinical hypothyroidism gives better results in the management of menstrual irregularities ,infertility and pregnancy .