Diffusive non-toxic goiter and purbatic course in girls





girls, puberty, diffuse non-toxic goiter


Objective of the study. To study the peculiarities of the puberty course in girls with diffuse non-toxic goiter (DNG) and justify an individual approach to prevention of its disorders.

Materials and methods. Compares the features of the puberty course and state of the thyroid system in girls with DNG (main group), which was first diagnosed at 9–13 years in the prepubertal period (n = 51) and early puberty (n = 58). The comparison group consisted of 107 peers with a normal thyroid volume, harmonious physical development and physiological course of puberty. An ultrasound of the thyroid gland was performed; thyroid stimulating hormone (TSH) value, free fractions of thyroxine (fT4) and free triiodothyronine (fT3) in blood were determined, TSH/fT4 ratios and fT3/fT4 ratios were calculated in conventional units. Sexual development and puberty course were also studied.

Results. An individual analysis of sexual development during the initial examination allowed us to determine its normal character in 90.0% girls with disabilities, 6.4% recorded an acceleration of its pace for 1–2 years, and only 2 girls (1.8%) 13 years old were diagnosed with a slowdown pace of puberty. Two (1.8%) 10-year old girls had inverted puberty. It was found that an earlier onset of puberty occurs with an increase in TSH and fT3 levels against the background of normal fT4. Dynamics of observation showed an increase of patients with signs of thyroid failure, which was accompanied by a delay in sexual development in 11.1% and menstrual dysfunction in 28.0% girls.

Conclusion. Girls with DNG identified in pre- and early puberty increase the risk of delayed sexual development and menstrual dysfunction, which is the rationale for therapy aimed at correcting and preventing the progression of thyroid dysfunction. The feasibility of using potassium iodide and/or L-thyroxine in order to prevent violations of the puberty course in girls with DNG is substantiated

Author Biographies

С. І. Турчина, SI “Institute for Children and Adolescents Health Care of the NAMS of Ukraine”; V.N. Karazin KNU; KMAPE, Kharkiv

MD, senior researcher, head of the Endocrinology Department

professor of the Department of Hygiene and Social Medicine, Faculty of Medicine;

associate professor, Department of Endocrinology and Pediatric Endocrinology

В. О. Динник, SI “Institute for Children and Adolescents Health Care of the NAMS of Ukraine”; V.N. Karazin KNU, Kharkiv

MD, researcher, deputy director;

professor of the Department of Hygiene and Social Medicine, Faculty of Medicine


  1. Tatarchuk, T.F., Davydova, Y.V., Kosyanchuk, N.Y. “Thyroid homeostasis and woman reproductive health.” Int Endocr J 3.9 (2007): 66–70.
  2. Andreeva, P. “Thyroid gland and fertility.” Akush Ginekol (Sofiia) 53.7 (2014): 18–23.
  3. Cho, M.K. “Thyroid dysfunction and subfertility.” Clin Exp Reprod Med 42.4 (2015): 131–5.
  4. Urmi, S.J., et al. “Hypothyroidism and its Effect on Menstrual Pattern and Fertility.” Mymensingh Med J 24.4 (2015): 765–9.
  5. Titenko, T.M. “Dysfunction of the thyroid gland and the peculiarities of reproductive health of the adolescent girls.” Pediatrics, obstetrics and gynecology 1 (2006): 98–100.
  6. Bachinska, I.V. “Establishment of menstrual function and hormonal homeostasis of the adolescent girls with autoimmune thyroiditis.” Reproductive endocrinology 5.31 (2016): 60–4.
  7. Tsisar, Y.V. “The role of thyroid pathology in the development of menstrual function in adolescent girls.” Bukovinian medical herald 1.89 Vol. 23 (2019): 135–9.
  8. Weber, G., Vigone, M.C., Stroppa, L., Chimello, G. “Thyroid Function and puberty.” J Pediatr Endocrinol Metab 16.2 (2003): 253–7.
  9. Zelіnska, N.B., Rudenko, A.G., Globa, E.V., et al. “Pediatric endocrinology in Ukraine at 2018.” Ukr. journal of pediatric endocrinology 1 (2019): 7–15.
  10. Turchina, S.I. “Diffuse non-toxic goiter and puberty.” Ukr. journal of pediatric endocrinologe 1 (2013): 23–8.
  11. Vasechkina, L.I., Abramova I.Y., Tyurina, T.K. “Features of growth and development of adolescents against the background of changes in thyroid status in conditions of iodine deficiency.” Pediatrics 5.9 (2003): 19–24.
  12. Pankiv, V.I., Litvak, E.O. “Diseases of the thyroid gland and the reproductive function of women.” Medical aspects of women's health 7.47 (2011): 62–5.
  13. Levenets, S.O., Nachеtova, T.A., Perevozchikov, V.V., et al. “The prevalence of disorders of the function of the sexual system among modern girls and adolescent girls and the risk factors for their occurrence.” Pediatrics, obstetrics and gynecology 6 (2010): 94–6.
  14. Turchina, S.I., Nachetova T.A. “Distyroidism is a factor of the form of secondary amenorrhea in girls living in mild iodine deficiency.” Women's Health 8.124 (2017): 14–16.
  15. Protocols on medical assistance to children for the specialty “Child Endocrinology”. Kyiv (2006): 94 p.
  16. Tumilovich, L.G., Salnikova, G.P., Dzyuba, G.I. “Assessment of the degree of girls sexual development.” Obstetrics and gynecology 3 (1975): 54–7.
  17. Levenets, S.O., et al.; SI “ICAHC of the NAMS of Ukraine”. Identification of disorders of the sexual system’ functions and their prevention in girls in modern conditions. Methodical recommendation. Kyiv (2011): 20 p.
  18. Mamenko, M.E., Erokhina, O. І. “Subclinical hypothyroidism in children with mild iodine deficiency.” Ukrainian Medical Almanakh 11.6 (2008): 113–5.
  19. Vlasenko, M.V. Diffuse non-toxic goiter in adolescents: genesis, diagnosis, diagnosis. Thesis abstract for MD degree, specialty 14.01.14. Kyiv. V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine (2008): 39 p.
  20. “Changes of the thyroid status of adolescents with diffuse non-toxic goiter at the stages of puberty.” Probl endocr pathol 4 (2010): 19–25.
  21. Turchina, S.I. “The effect of differential therapy on somatogenital development of adolescents with diffuse non-toxic goiter.” Medical business 5–6 (2015): 87–93.



How to Cite

Турчина, С. І., & Динник, В. О. (2019). Diffusive non-toxic goiter and purbatic course in girls. REPRODUCTIVE ENDOCRINOLOGY, (49), 29–33. https://doi.org/10.18370/2309-4117.2019.49.29-33