Period Problems and Hypothyroidism

By: | Tags: | Comments: 0 | August 3rd, 2011

When you are experiencing menstrual irregularities, you may not need to look any further than your thyroid for the cause. Some studies have reported that as many as three out of four women with thyroid conditions have some form of menstrual problem – a rate that is two to three times higher than for women without thyroid problems.
 
Here is an overview of some of the menstrual problems that can affect you if you’re hypothyroid.
 
Many women experience premenstrual syndrome – also known as PMS – but thyroid patients are at a greater risk, and often experience more intense or debilitating symptoms. PMS is typically related to the hormonal changes that take place in the week to 10 days before your period starts. Some common PMS symptoms include:
 
*    bloating, fluid retention
*    breast tenderness
*    fatigue
*    insomnia
*    headaches
*    cramps
*    food cravings
*    tension, irritability
*    anxiety, depression
*    trouble concentrating
 
Dysmenorrhea is the medical term for painful periods. Primary dysmenorrhea means that there’s pain, but no traceable reason. Secondary dysmenorrhea is painful periods, but with a physical cause, such as endometriosis. The main sign of dysmenorrhea is cramps. Severe dysmenorrhea, which affects 1 in 10 women, and appears to be more common in thyroid patients, can include nausea, vomiting, dizziness and diarrhea. Typically, dysmenorrhea begins in the several hours before the period starts, and lasts no more than around 3 days.
     
Oligomenorrhea refers to cycles that are repeatedly longer than 35 days — or only 4 to 9 periods per year.
 
Polymenorrhea refers to repeated cycles of less than 21 days, or menstruation at 2 to 3-week intervals.
 
Metrorrhagia refers to bleeding at irregular intervals, such as between menstrual periods. Metrorrhagia can range from light spotting, to continuous bleeding for weeks. While occasional spotting in women is not unusual, frequent metrorrhagia needs evaluation, and it should always be evaluated in pre-pubescent girls, women who are post-menopausal and not on hormone therapy, and women who have had a hysterectomy.
 
Menorrhagia refers to a very heavy or excessive period. Excessive means soaking through at least a pad or tampon an hour for several consecutive hours. Sometimes the term hypermenorrhea is used, and it refers to a more than 20% increase in the heaviness of the menstrual flow. Women with menorrhagia also frequently pass large blood clots, and may have excessive tiredness, fatigue or shortness of breath that could point to anemia due to excessive blood loss.
 
Evaluation of menstrual problems requires a multi-step evaluation by your doctor. Your doctor should take a complete medical history, focusing particularly on your personal and family reproductive history, your menstrual cycle, as well as thyroid and hormonal history.
 
A complete physical examination should look for obvious thyroid signs, including goiter or neck enlargement, swelling in hands, feet and face, hair loss (especially the outer edge of the eyebrows), and slowed reflexes.
 
The examination is also likely to include a pelvic exam, to look for evidence of structural or anatomic abnormalities, inflammation, polyps, cysts, tumors, infection, or other gynecologic conditions. Typically, a Pap test, and (if pre-menopausal), a pregnancy test, are also done. Your doctor will want to rule out structural, viral and other potential causes of menstrual irregularities.
 
The doctor should also consider other symptoms and issues that you might have, including:
 
*    breast discharge
*    hot flashes
*    facial hair
*    headaches
*    vision problems
*    recent gynecologic procedures
*    weight, diet or exercise changes
 
Finally, blood and/or saliva tests to evaluate various hormone levels – including thyroid, estrogen, FSH, LH, and prolactin — may be run.
 
Because hypothyroidism is so often the culprit when it comes to irregular or problematic periods, it’s essential that your doctor know how to diagnose and effectively treat an underactive thyroid. For some women, simply getting properly diagnosed and optimal treatment for the thyroid problem – often for the first time in their lives – will restore their menstrual cycles and flow levels to a more normal pattern!
 
If undiagnosed or undertreated thyroid problems are not at the root of your menstrual irregularities, or thyroid treatment fails to normalize your menstrual cycles and resolve problems, your doctor’s next steps will be to perform additional tests. In some cases, doctors order imaging tests such as ultrasound, MRI or CT scans, to help pinpoint the cause. Ultimately, your doctor should be able to recommend an effective treatment plan for you.
 
(June 2006)
 
Mary Shomon is an internationally-known thyroid patient advocate, and is author of a number of best-selling health books, including Living Well With Hypothyroidism and The Thyroid Diet. Since 1997, she has run the Internet’s most popular thyroid patient sites: About.com Thyroid Site  and Thyroid-Info.com. 

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