Establishment of menstrual function and hormonal homeostasis in adolescent girls with autoimmune thyroiditis

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.