Περίληψη:
OBJECTIVES In thyroid textbooks it is stated that hyperthyroidism in
women may be associated in almost 50% of the cases with hypomenorrhoea,
oligomenorrhoea or amenorrhoea and perhaps with reduced fertility. Our
experience at a busy thyroid clinic has given a picture which differs
from that described in the literature. Most of our female thyrotoxic
patients had normal menstruation. This study was performed to define the
menstrual abnormalities in hyperthyroidism.
DESIGN AND PATIENTS We investigated the menstrual history, starting 6
months before the discovery of the disease, the smoking habits and the
body mass index (BMI), in 214 female, premenopausal thyrotoxic patients
and a similar number of normal controls matched for age and weight.
MEASUREMENTS TT4 and TT3 were measured by radioimmunoassay, while BMI
was calculated from the ratio of body weight in kg to height in m(2).
RESULTS Of the 214 patients, 168 (78.5%) had regular menstrual cycles
and 46 (21.5%) irregular cycles. No difference in BMI was found between
the patients with or without menstrual abnormalities. Out of the 46
patients with irregular periods, 23 (50%) were smokers, while only 32
out of the 168 patients (19%) with normal periods were smokers (P <
0.001). TT4 levels were higher as a group in patients with menstrual
disturbances (mean +/- SD 267.7 +/- 66.9 nmol/l) than in those with
normal periods (240.6 +/- 47.6 nmol/l) (P < 0.05). The 23 smokers with
irregular periods had higher TT4 levels (280.5 +/- 51.8 nmol/l) than the
remaining non-smokers from the same group (241.9 +/- 43.7 nmol/l) (P <
0.01). No such differences were found for TT3 levels. Out of 214 normal
controls, matched for age and weight, 196 (91.6%) had normal
menstruation and 18 (8.4%) irregular cycles. The latter group included
mainly women with oligomenorrhoea. Out of 18 normal controls with
irregular periods, 6 (33.3%) were smokers, while 57 (29.1%) out of 196
with normal periods were smokers.
CONCLUSIONS These data demonstrate that hyperthyroidism in women is less
frequently associated with menstrual abnormalities than was previously
believed. Furthermore, no patient presented with amenorrhoea. Smoking
and TT4 levels are strongly associated with the occurrence of menstrual
disturbances in thyrotoxicosis.
Συγγραφείς:
KRASSAS, GE
PONTIKIDES, N
KALTSAS, T
PAPADOPOULOU, P and
BATRINOS, M
