Становлення менструальної функції та гормональний гомеостаз дівчат-підлітків, хворих на аутоімунний тиреоїдит

І. В. Бачинська

doi:10.18370/2309-4117.2016.31.60-64

Authors

І. В. Бачинська National Children’s Specialized Hospital “Okhmatdyt”, Ukraine https://orcid.org/0000-0002-6591-8213

DOI:

https://doi.org/10.18370/2309-4117.2016.31.60-64

Keywords:

pubertal period, adolescent girls, autoimmune thyroiditis, thyroid gland function disruption, menstrual cycle disorders, reproductive function, autoimmune oophoritis

Abstract

It is known that the frequency of thyroid pathology is higher among females regardless of age. Thyroid disorders may cause late sexual maturation, disrupt the ovarian menstrual cycle and later negatively affect the development of an adolescent’s reproductive system.

Chronic autoimmune thyroiditis plays the leading role in the family of thyroid pathologies; AIT is the main cause of acquired primary hypothyroidism in children and adolescents, setting the background for observed menstrual function abnormalities. This pathology’s role in the development of autoimmune disruption of ovaries remains undefined.

Aim of the research was to study the course of the pubertal period, the development and character of menstrual cycle disruptions, hormonal homeostasis and presence of thyroidal and ovarian antibodies in adolescent girls with AIT. To achieve the objective set, 95 girls aged 16–18 were examined: 50 ill with AIT (main group) and 45 without thyroidal pathology (control group). All the girls’ physical condition and sexual development were evaluated according to Tanner’s Formula, determining gonadotrophic, sex and thyroidal hormones, thyroidal peroxidase antibodies and antiovarian antibodies.

The results obtained allow us to make the following conclusions, in that the girls with AIT were more physically developed than their peers. Secondary sex trait development in girls with AIT was higher, however in parallel with this a part of these girls also had retarded sexual maturation. AIT negatively impacts the development of the menstrual cycle by giving rise to disruptions starting at menarche. It has been determined that girls with AIT have decreased estradiol and progesterone, heightened LH, prolactin hormone and testosterone, indicating the pathological influence at all points regulating the menstrual cycle. Thyroid function disruption level negatively affects the legal of menstrual cycle disruption, with the greatest hormonal disruptions evidenced in the group of AIT and hypothyroidism patients. Determination of AOAT did not have diagnostic significance in this age group however there was evidence of a correlation between heightened AOAT in girls with AIT and hypomenstrual syndrome, as well as the group with subclinical hypothyroidism.

Author Biography

І. В. Бачинська, National Children’s Specialized Hospital “Okhmatdyt”

Physician at the child and adolescent gynecology department

References

Demina, T.N., Alipova, N.F. “Autoimmune thyroiditis and reproductive function of women.” News of medicine and pharmacy. Obstetrics, gynecology, reproduction 275 Thematic issue (2009).
Pankiv, V.I. “The influence of thyroid disorders upon the female reproductive function. Modern possibilities of phytotherapy.” Reproductive endocrinology 1 (2016): 52–7.
Pankiv, V.I. “Thyroiditis.” International Journal of Endocrinology 6 (2012).
Tatarchuk, T.F., Kosei, N.V., Islamova, A.O. “Thyroid homeostasis and dishormonal disorders of the reproductive system of women.” Endocrine Gynecology. Clinical essays 1 (2003): 303.
Tsysar, Y.V., Andriets, O.A. “The influence of thyroid disease in menstrual function of pubertal age girls.” Bukovina Medical Herald 2.58 (2011).
Andreeva, P. “Thyroid gland and fertility.” Obstet Ginekol 53 (2014): 18–23.
Brown, R.S. “Autoimmune thyroiditis in childhood.” Journal of Clinical Research in Pediatric Endocrinology 5 (2013): 45–9.
Fairweather, D., Frisancho-Kiss, S., Rose, N.R. “Sex differences in autoimmune disease from a pathological perspective.” The American Journal of Pathology 173 (2008): 600–9.
Hasan, Z., Omran, Z.S., Mousa, M. “Assessment of thyroid function in infertile Iraqi females.” Journal of Health, Medicine and Nursing 25 (2016): 60–3.
Jefferys, A., Vanderpump, M., Yasmin, E. “Thyroid dysfunction and reproductive health.” The Obstetrician & Gynecologist 17.1 (2015): 39–45. DOI: 10.1111/tog.12161
Kostoglou-Athanassiou, I., Ntalles, K. “Hypothyroidism – new aspects of an old disease.” Hippokratia 14 (2010): 82–7.
Krassas, G.E., Poppe, K., Glinoer, D. “Thyroid function and human reproductive health.” Endocrinology Review 31 (2010): 702–55.
Mahnaz, A., Masoumeh, F., Babak, E., Reza, S.Y. “The presence of antithyroid and antiovarian auto-antibodies in familial premature ovarian failure.” IJFS 4 (2008): 171–4.
Mobeen, H., Afzal, N., Kashif, M. “Polycystic ovary syndrome may be an autoimmune disorder.” Scientifica (2016). Available from: [https://www.hindawi.com/journals/scientifica/2016/4071735/], last accessed Oct 27, 2016.
Ngoa, S.T., Steyna, F.J., McCombe, P.A. “Gender differences in autoimmune disease.” Frontiers in Neuroendocrinology 35.3 (2014): 347–69.
Saran, S., Gupta, B.S., Philip, R. “Effect of hypothyroidism on female reproductive hormones.” Indian Journal of Endocrinology and Metabolism 20 (2016): 108–13.