Women's Health Specialists of St. Louis
Obstetrics and Gynecology

Articles - Hypothyroidism

The thyroid is a small gland in the neck which has an important role in the maintenance of normal metabolism. Abnormal thyroid function is almost ten times more common in women than in men. It is more common in women who have a past medical history of Type I diabetes, an autoimmune disorder, or a family history of thyroid disorders. The most common cause of thyroid abnormalities is when the body produces antibodies against the thyroid gland. The antibodies may either reduce its ability to function normally or over stimulate the thyroid to function. The term used for under active thyroid is hypothyroidism. When the thyroid is over active, the term hyperthyroidism is used.

Hypothyroidism is estimated to affect 4% of all women and the risk of developing a thyroid abnormality increases with age. More than 15% of all women over the age of 60 will have hypothyroidism. When the thyroid is not functioning adequately to produce enough thyroid hormone, women may experience symptoms. These symptoms may include: menstrual irregularities, fatigue, cold intolerance, weight gain, joint pain, and constipation. These non-specific complaints are often experienced by women who are perimenopausal and may be related to the hormone changes that are occurring rather than by changes in thyroid function. The only way to know if these symptoms actually represent decreased thyroid function is to perform a blood test. Women over 50 should be screened every 5 years according to the American Thyroid Association. Women at increased risk should also be screened regularly. Treatment of hypothyroidism is achieved with a once daily thyroid hormone pill. Women of reproductive age who have hypothyroidism may have difficulty conceiving until the hormone levels are corrected. Thyroid hormone replacement is safe to use in pregnancy. As the growing pregnancy increases the metabolic demands of the body, there is an increased demand for thyroid hormone. Women with hypothyroidism in pregnancy have routine blood tests and the thyroid replacement is increased as necessary.

Hyperthyroidism is less common than hypothyroidism and affects approximately 2% of all women. It is more common in women of reproductive age. The symptoms may include sleeplessness, weight loss despite constant hunger, heat intolerance, and nervousness. If untreated, hyperthyroidism may trigger an uncontrolled increase in metabolism called a thyroid storm. A thyroid storm is a life threatening emergency where the increase of metabolism results in heart failure. Treatment of hyperthyroidism or thyroid storm requires the use of anti-thyroid medications, medications to reduce symptoms, and in some cases surgical removal of the thyroid.

Though thyroid disorders are common in women they are thankfully treatable. Women who are at risk because of a personal history of an autoimmune disorder or a family history of thyroid disorders should discuss screening with their physicians. Women who think they may have symptoms of a thyroid disorder should follow up with their physicians. All women over the age of 50 should be screened every 5 years.