Why Women Should Monitor Their Thyroid Function

June 17, 2022

Endocrinologist examining throat of young woman

The thyroid is a tiny gland with a big job. Located in the neck just above the collarbone, the hormones released by this butterfly-shaped endocrine gland play a crucial role in regulating many body functions, including energy levels, heart rate, growth, onset of puberty, metabolism and mood. It does this by releasing a steady amount of thyroid hormones into the bloodstream.

If the thyroid is not functioning properly and releases too much or too little of these hormones, it can lead to a variety of symptoms, including:

Fatigue
Dry skin
Thinning hair or hair loss
Weight gain and/or puffiness
Bowel changes (frequency, diarrhea, constipation)
Hoarse voice
Muscle weakness
Sleep disturbances
Muscle cramps
Inability to focus
Irregular or absent menstrual periods

Monitoring thyroid function is important for both genders; however, thyroid issues are far more common in women than men. It is estimated that one in eight women will suffer from thyroid problems at some point during her life. And hormonal imbalances due to thyroid disorders can have serious reproductive consequences for women.

Fertility and Thyroid Disorders in Women

Thyroid hormones play an essential role in regulating a woman’s reproductive system. Abnormally high or low levels of thyroid hormones can have significant, even life-changing effects, particularly on women of childbearing age – largely because thyroid levels in the mother can greatly affect both her ability to conceive and the development of her unborn baby.

Let’s take a closer look at the two most common thyroid disorders and how they affect women.

Hypothyroidism

This is a condition in which the thyroid gland does not produce enough thyroid hormones. It is often caused by Hashimoto’s disease (an autoimmune disease), but can also occur after surgical removal of the thyroid or radiation exposure to the thyroid. It may also develop postpartum, typically 2 to 4 months after giving birth. In some women, postpartum hypothyroidism will resolve on its own while for others the condition will be permanent.

Untreated, hypothyroidism can interrupt or prevent ovulation, making it difficult to conceive. In women who do become pregnant, low thyroid hormones can increase the chance of miscarriage, stillbirth, preterm delivery and postpartum hemorrhage. In addition, untreated hypothyroidism in the mother can adversely affect fetal brain development with some studies showing that even mild hypothyroidism during pregnancy can lead to developmental brain abnormalities in the fetus.

The good news is hypothyroidism can be treated with a thyroid hormone prescription. Even if the condition is discovered during pregnancy, once treatment begins and the hormone levels are normalized (ideally in the first trimester) the chances of fetal disease or defect are very low. The best plan, however, is to know your thyroid hormone levels before you get pregnant. “It is also advisable to have your thyroid levels checked again within 6 weeks of becoming pregnant if you or a close family member have a pre-existing thyroid condition or any other autoimmune illness. The same recommendation would apply if you start to use an oral contraceptive, as this can also influence thyroid levels in a manner similar to pregnancy and alter your thyroid balance,” says Baha Arafah, MD, FACP, Chief of Endocrinology at University Hospitals.

Hyperthyroidism

Hyperthyroidism is a condition in which the thyroid produces too much thyroid hormone. It is often caused by Graves’ disease, an autoimmune disorder. Symptoms may include insomnia, weight loss despite increased food intake, frequent bowel movements, hand tremors, rapid and often irregular heartbeat, light or irregular menstrual cycles and bulging of the eyes.

Hyperthyroidism can also cause symptoms that mimic menopause, including hot flashes, mood swings, insomnia and lack of menstruation, which can affect the ability to conceive. In women who do get pregnant, an overactive thyroid puts them at risk for more severe morning sickness.

There are many different ways to treat hyperthyroidism, including medications and/or surgery to remove all or part of the thyroid gland. In pregnant women, the treatments must be carefully tailored to ensure fetal and maternal well-being. Again, it’s best to know your thyroid status before getting or attempting to get pregnant.

Talk to Your Doctor

The good news is, thyroid problems are very treatable once diagnosed.

If you are a woman and haven’t had a thyroid function test done recently (or ever), talk to your primary care provider or your OB/GYN about getting tested, particularly if you are having unexplained symptoms, are pregnant or thinking about getting pregnant. And, be sure to discuss the results with them – if all is well, further testing may not be needed unless symptoms appear down the road.

If thyroid hormone levels are either too high, or too low, you may be referred to an endocrinologist who will then manage your treatment. Once your hormone levels are normalized, the doctor will determine how often you need to be retested.