Репродуктивне здоров’я і дисфункція щитоподібної залози

Abstract

Diseases of thyroid gland, according to world statistics, are found in almost 30% of the world’s population. Thyroid dysfunctions, according to many epidemiological studies, are quite widespread in the population. Normal development of the reproductive system occurs under the influence of gonadotropic hormones of the pituitary gland and during normal functioning of the thyroid gland. In turn, the state of the reproductive system has a pronounced effect on the function of the thyroid gland, as evidenced by changes in its function during pregnancy and lactation, in patients with abnormal uterine bleeding, in girls during puberty and women during the menstrual cycle. The objective: is to evaluate the prevalence and effectiveness of diagnosis of dysfunction of thyroid dysfunction in women with reproductive health disorders to improve treatment and rehabilitation activities and quality of life. Materials and methods. In the first stage of a prospective study, 989 women of reproductive age were put through the method of continuous sampling. Based on the results of verifying the gynecological pathology, 350 patients who gave informed consent for participation in the second stage of the study, were divided into clinical groups for further comparative analysis of the prevalence of dysfunction of thyroid gland: I group – 159 (51.3%) patients with combined non-hormonal non-inflammatory pathology of reproductive organs and dyshormonal pathology of the mammary glands (genital endometriosis, adenomyosis / uterine leiomyoma in combination with endometrial hyperplasia), II group – 31 (8.9%) female with PCOS, III – 53 (15.1%) with endometriotic disease, IV group – 57 (16.3%) women with uterine leiomyoma. Absence of gynecological pathology and pathology of mammary glands at the time of the survey was found in 50 (14.3%) of women, which amounted to V group. Results. Structural and functional changes of the thyroid gland were found in 53.4% of women, while the frequency of detection of diffuse goiter I–II st. did not differ between clinical groups (p>0.05). The prevalence of autoimmune thyroiditis was higher in patients with dyshormonal pathology of the reproductive system than in healthy women (p=0.0001). The euthyroid state with combined dyshormonal and proliferative pathology occurred 1.5 to 1.9 times less frequently than in patients of other groups (p≤0.0005). Subclinical hypothyroidism was diagnosed in 39,6% of the I group of women at 12.9%, 15.1% and 14.0% in the II, III and IV groups, respectively. At the same time, the incidence of subclinical hypothyroidism was 60.6% for the I group in women who had diffuse goiter and / or autoimmune thyroiditis, with 8.6% of the manifest hypothyroidism that was absent in women with PCOS, and the prevalence of endometriosis disease and uterine leiomyomies were 1.9% and 3.5%, respectively. Conclusion. Thus, the results of a two-stage study of thyroid gland thyroid dysfunction in women with dyshormonal pathology of reproductive organs of non-inflammatory genesis confirm that dysfunction of the thyroid gland, especially hypothyroidism, is a serious problem for reproductive health, requiring changes in diagnostic and therapeutic approaches. Key words: thyroid gland, autoimmune thyroiditis, hypothyroidism, reproductive health, non-inflammatory dyshormonal diseases of reproductive organs.