Thyroid problems in women: when to get checked

The functioning of the thyroid gland can be affected in various ways, with resulting changes having a range of effects on women’s health. In this article, a consultant endocrinologist provides an overview of the consequences of thyroid issues in women specifically, and how female patients can know when something is wrong.

What is the thyroid?

The thyroid, located in the throat, is a butterfly-shaped endocrine gland that produces hormones. It converts the mineral iodine -- which is present in common foods like milk, eggs, salt, and fish – into hormones called thyroxine and triiodothyronine. It works in conjunction with the parts of the brain called the hypothalamus and the pituitary gland in a system creatively called the hypothalamic-pituitary-thyroid axis (or HPT axis). It controls the metabolic rate of the body (how your body converts food into energy), which in turn determines how we function, grow, and develop.

When the thyroid stops working as it should, it disrupts the entire body system and greatly impacts health. The thyroid can either underperform, called hypothyroidism, or overperform, called hyperthyroidism.

How do thyroid problems affect women?

The biggest impact of thyroid problems in women is on reproductive function due to imbalanced hormones. Throughout their lives, women can be affected in different ways:

• Puberty and menstruation: can cause puberty and the first menstruation to come too early or too late. Can also influence the flow of blood to be very light or too heavy, as well as disrupting the normal period cycle to become irregular or even absent (amenorrhea).
• Conception: normal ovulation can become disrupted, either by the ovaries failing to release an ovum; cysts may form on the ovaries, obstructing the fallopian tubes, as is a higher possibility with hypothyroidism; or by stimulating prolactin production in the breasts, which in turn prevents ovulation.
• Pregnancy and postpartum: hypothyroidism can be dangerous for embryos, and can lead to pre-eclampsia, miscarriage, preterm birth, or stillbirth. In the mother, it can lead to heart failure, haemorrhaging, and postpartum thyroiditis. Hyperthyroidism can also result in these conditions, as well as extreme morning sickness.
• Menopause: as thyroid problems can disrupt menstruation, some patients may undergo or believe they are undergoing early menopause in their late 30s to early 40s due to similar symptoms such as hot flashes, issues with sleep, irregular or non-occurring periods, bone density loss (osteoporosis), reduced libido, and mood swings.

How can women get their thyroid problems checked?

As the symptoms of thyroid issues can often be mistakenly attributed to other conditions or ailments, one of the best ways to assess thyroid function is with simple blood tests that measure the level of thyroid hormones in the blood. With the results of these tests, doctors can easily see if the thyroid is under- or overfunctioning.

Women experiencing disordered periods, difficulty with conception, pregnancy, or postpartum, high blood pressure and cholesterol, swelling in the neck, and/or osteoporosis or brittle bones should seek blood testing as a way to initiate their treatment journey.