BENGALURU: Thyroid disease is the second most common endocrine disorder after diabetes found in women of childbearing age. Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can lead to female infertility by causing conditions like loss of libido and irregular periods. Unmanaged thyroid disease can also have adverse effect on mother and foetus. It increases the risk of miscarriage, premature birth, preeclampsia (high blood pressure leading to damage to the liver and kidneys), and still birth. It also affects the brain development of the newborn, severe form of which is called cretinism.
Two to three percent of women with fertility problems suffer from an overactive thyroid. Graves’ disease, an autoimmune disorder, can often lead to this condition and is a common cause of infertility. The most common complications of hyperthyroidism in pregnant women is preeclampsia. Other complications can be miscarriage, pre-term labour, heart failure or still birth. Risks to foetus include low birth weight and an excess of thyroid hormone in the foetal body.
The prevalence of hypothyroidism among women of reproductive age is 2-4 per cent. Low levels of thyroid hormone can interfere with the release of egg from the ovary, leading to difficulties in conceiving. Symptoms of hypothyroidism can be overlooked in a pregnant woman because some of these mimic hormonal changes that occur in normal pregnancy, such as tiredness and weight gain.
Pregnant women with uncontrolled hypothyroidism can suffer from blood pressure, anaemia, muscle pain and weakness. There is also an increased risk of miscarriage, premature birth and still birth. Foetal risks include low birth weight, prematurity and respiratory distress in the newborn child. Since thyroid hormone is essential for foetal brain growth, children born to untreated hypothyroid women run the risks of having lower IQ.
Fortunately, most conditions related to thyroid are treatable. If women have preexisting thyroid problems, they need more medical attention to keep these conditions under control. For women with hyperthyroidism, anti-thyroid medication that blocks production of the thyroid hormone is used. Hypothyroidism on the other hand is treated with a synthetic hormone called levothyroxine. The dose needs to be adjusted by thyroid function test every 4-6 weeks during pregnancy.
Symptoms
For hyperthyroidism in pregnant women
Irregular heartbeat
Heightened nervousness
Nausea and vomiting,
Tremors, troubled sleep
For hypothyroidism
Constipation Difficulty in concentrating
Memory problem
Sensitivity to cold temperature
(The writer is medical director, Radhakrishna Multispecialty Hospital)