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HypothyroidismHypothyroidism & Your Menstruation Cycle: What's the Connection?Hypothyroidism is a condition where the thyroid gland, a butterfly-shaped organ located at the back of the throat, doesn't produce sufficient hormones. This is quite common, with a National Library of Medicine study showing an 11.7% prevalence in the United States. Plus, women are 5-8 times more likely to have thyroid troubles than men. Hypothyroidism results from inadequate thyroxine production because of nutrient depletion. Low thyroxine can slow down bodily functions, like metabolism, growth, and mood regulation. It can also impact heart rate and temperature. But how does the thyroid hormone affect menstruation? Natasha Hogan—healthcare professional, researcher, and author of Pregnancy After Infertility: A Guide to What’s Next & What’s Different—provides clarity on the connection between hypothyroidism and your menstruation cycle. Understanding Hypothyroidism Two main factors cause hypothyroidism: Iodine deficiency disorders, developmental and functional disorders caused by lowered thyroid hormones. These are prevalent because of poor soil nutrients in certain regions and affect the iodine in foods.Hashimoto's disease, an autoimmune disorder where the body attacks its own thyroid tissue The likelihood of developing hypothyroidism increases with age. "Over time, our bodies wear down, and the nutrients necessary for thyroid function may deplete," explains Hogan. Common hypothyroidism symptoms include: FatigueConstipationDry skinWeight gainCold sensitivityA goiter (a visible lump in the neck) due to severe iodine deficiencyJoint and muscle pain (specific to Hashimoto's disease)Mood disturbances and growth issues (particularly in children) Influence on Thyroid Stimulating Hormone (TSH) TSH plays a crucial role in the natural cycle, affecting the luteinizing hormone (LH), the follicle-stimulating hormone (FSH), and growth hormone levels. If there's not enough TSH, then the fluctuations necessary for a healthy period cycle may not occur, leading to reduced estrogen and less chance for an embryo to attach to the uterine wall. Regular TSH levels help maintain the right balance, assuring natural mechanisms function routinely.Increased TSH levels lead to a surge in LH, preparing the ovum and triggering an increase in basal body temperature (BBT).Low TSH levels mean ovulation likely won't occur, and you'll miss the chance to become pregnant. Your luteal phase, which occurs post-ovulation and before menstruation, and cycle may shorten. Does TSH fluctuate during a menstrual cycle?During ovulation, LH and FSH peak, but after the 16th day, TSH and related hormones should start to reduce, and the BBT will remain elevated. This temperature level, partly indicative of TSH levels, will stay up if you are pregnant, have inflammation, or have an infection. And after ovulation, there's more progesterone, which helps keep the temperature warm during the luteal phase. Hypothyroidism and Menstrual Cycles: In-Depth Hypothyroidism symptoms in females often relate to menstrual cycle disruptions. The pituitary gland and hypothalamic-pituitary-thyroid (HPT) axis both play vital roles in facilitating hormone production. It can contribute to conditions like polycystic ovary syndrome (PCOS), leading to higher testosterone levels in women. Interfered sex hormones, including estrogen, FSH, and DHT (an androgen) can lead to ovarian pathology in women, such as anovulation and cysts. Impact on Periods Irregular periods—caused by low progesterone levels—can shorten various parts of the menstrual cycle, including the luteal phase. This irregularity in conjunction with hypothyroidism can manifest the following: Missing periods (periods may only occur every six months or even longer)Extended heavy periods at the start of a cycle, which can cause fatigue and iron and zinc deficienciesMore frequent menstruation, like periods every 2 weeksOvulation between day 16 and 21 of the cycle instead of the usual days 12 to 16, impacting the ability to conceiveIdentifying ovulation with BBT tracking for peak conception times can be challenging Effect of Thyroid Hormone on Menstruation A 28-day cycle is desirable, but understanding what's happening in the cycle is crucial, especially when thyroid issues are present. In this case, tracking BBT results may not provide an accurate view of hormonal imbalances when the hormones are not functioning in their correct pattern to start with. Your doctor can help check this and might administer regular blood tests. And hormone tracking tests should be done at the same time daily to ensure the most reliable results. Hypothyroidism in young people, in particular, may go unnoticed, especially if it's subclinical without other symptoms. This lack of diagnosis can be dangerous, as low thyroid levels during pregnancy can lead to complications. Therefore, it's wise to consult a fertility specialist who will ensure that TSH and other vital factors are adequately managed, supporting healthy reproductive health. Differentiating between hypothyroidism and hyperthyroidism is crucial, as the two conditions vary greatly and can present complex combinations of symptoms that affect ovulation. » Find out how tracking BBT may reveal undiagnosed hypothyroidism Treatment Options for Hypothyroidism Interestingly, hypothyroidism is also the symptom of a root cause which is inflammation, especially if you are fully diagnosed with Hashimoto's disease. It's not just the lack of thyroid hormones or nutrition to make T cells, but also an irritation of your body's systems that makes the thyroid hormones. So, managing this condition can help alleviate symptoms that affect your menstrual cycle and overall reproductive well-being. However, all changes or treatment adjustments should be made under the advisement of healthcare providers. Dietary Modifications and Supplementation Increasing the intake of nutrients like iodine and selenium may improve hormone secretion and alleviate symptoms, such as poor sleep cycles caused by nutrient deficiencies and hormone imbalances. Some food sources and nutrients to help manage thyroid health include: Kelp, which contains high iodine contentIodized saltMicronutrients, like selenium, in organ meats and Brazilian nutsZinc in oysters, meats, poultry, and legumesDark chocolate, pumpkin seeds, and leafy greens for magnesium, which helps with iodine absorptionOmega-3 fatty acids found in sardines, salmon, and chia seeds Hogan advises, "Remember that while it's crucial to ensure adequate nutrient intake, excessive supplementation combined with high-nutrient foods might tip the balance too far, leading to other health issues." Hormone Replacement Therapy For those with severe hypothyroidism, a synthetic thyroid hormone (levothyroxine) can be administered. This therapy can help regulate the body's hormone levels and may address irregular periods caused by thyroid issues, which can improve the chances of conception. Hogan explains how this therapy can affect your cycle here: "The body, when deficient in nutrients, might hold onto them in a sort of 'starvation state,' delaying the process of normalization." Thyroid Medication So how does thyroid medication affect the menstrual cycle? "The beautiful part of receiving thyroid medication for hypothyroidism is the potential normalization of your cycle," says Hogan. This treatment can restore the more common 28-day cycle, assuming that's your individual pattern. However, always keep an eye on any side effects you may experience. For example: If your cycle becomes shorter than the standard 28 days and you experience more frequent or potentially heavier bleeding, it could be a sign that the medication is overstimulating you, making your hyperthyroidism symptoms more frequent and pregnancy more difficult to achieve due to shorter cycles.If the medication isn't working sufficiently, the cycles may expand, leading to longer times between periods, which can result in heavier cycles. Note: The catch-22 is that utilizing medication or a synthetic hormone can improve your cycle but doesn’t necessarily reduce inflammation. So, while it isn't a cure, it can alleviate symptoms. Mental Health Support While the aforementioned interventions can address the physical symptoms of hypothyroidism, there are emotional and psychological impacts to consider, particularly for women who have experienced infertility. Hypothyroidism impacts mood due to its role in metabolism regulation, which can lead to increased anxiety and mood swings. "Proactive management of hypothyroidism is critical for both maternal and fetal health, especially for those with a history of infertility," says Hogan. » Learn how to recognize healthy hormones by charting Help Keep Your Cycle In Check While hypothyroidism cannot be prevented, it can be managed effectively, especially among individuals at higher risk due to a history of autoimmune diseases, radiation therapy in the neck or head, goiters, or a family history of thyroid issues. Early detection can help prevent the disease from progressing and help minimize the impact it has on your menstruation. Leveraging tools like Tempdrop's fertility tracker—an easy-to-use way of monitoring BBT—and consulting with your doctors regularly about treatment specifics can help restore some balance and stability to your cycle. Hypothyroidism doesn't have to make your periods a nightmare.
HypothyroidismHypothyroidism & Fertility: The Impact on Reproductive HealthHypothyroidism is a health condition where the thyroid gland—a gland at the back of the throat—doesn't produce enough hormones. These hormones are essential messengers that relay information to the organs and tissues of the body, controlling various functions, including metabolism, heart rate, and basal body temperature (BBT). The condition went from affecting 9.5% to 11.7% of people between 2012 and 2019 in the United States. Despite hypothyroidism's prevalence among older adults, it has a significant impact on reproductive health because the thyroid forms part of the endocrine system—a gland network that produces hormones. We spoke to Natasha Hogan—a healthcare professional and author of Pregnancy After Infertility: A Guide to What's Next & What's Different—to gain valuable insight into hypothyroidism and its impact on fertility and reproductive health. Hypothyroidism: Causes & Symptoms Hypothyroidism can stem from two main issues: Iodine deficiency: Low iodine can be damaging to thyroid hormone production and reproductive health.Hashimoto's disease: This autoimmune disease causes the immune system to mistakenly attack and destroy the tissues of the thyroid gland. Some signs of hypothyroidism include constipation, dry skin, and unexplained weight gain. In relation to the two conditions that can cause hypothyroidism, some specific symptoms are: "Iodine deficiency's signs are less obvious and often lead to misdiagnoses," says Hogan. When severe, a goiter (enlarged thyroid gland that forms a noticeable lump in the neck) can develop.Hashimoto's disease can cause fatigue, cold intolerance, and joint and muscle pain. Hypothyroidism and Ovulation Hypothyroidism can significantly impact fertility by causing irregular menstrual cycles and often leading to heavier menstruation. This irregularity can disrupt the usual patterns of the menstrual cycle, including the luteal phase which follows ovulation and precedes menstrual bleeding. Some ways hypothyroidism affects ovulation are: Hormonal imbalances: Low progesterone levels and irregular periods (for instance, every 6 months or longer) can lead to nutrient deficiencies, particularly zinc and iron, which can cause fatigue and harm fertility.Ovarian cysts: Hypothyroidism and ovarian cysts correlate. Because hypothyroidism can interfere with sex hormones, cysts can form that cause irregular ovulation.Trouble determining ovulation: In a regular cycle, most women ovulate around day 14. But with prolonged bleeding and irregular cycles, ovulation can be delayed until between days 16 and 21, leading to a shorter luteal phase. So, pinpointing the best time to conceive can be challenging.Metabolic issues: These can affect the BBT, which is often used for fertility tracking. Hypothyroidism makes it difficult to measure this temperature increase indicative of ovulation.Hyperprolactinemia or high prolactin levels: The prolactin hormone impacts menstruation and fertility. When levels are elevated, it can lead to irregular menstrual cycles, decreased fertility, and lactation of milk production in the breasts unrelated to pregnancy. Those experiencing symptoms of hypothyroidism or who have a family history of the condition should start monitoring their cervical mucus and doing BBT tracking within the first six months of trying to conceive as these are easier to maintain and more affordable than ovulation tests. "Tracking hypothyroidism can indicate poor BBT and ovulation. These indications can help doctors determine the right tests to run, as hyperthyroidism and hypothyroidism have different impacts on fertility and require different treatment approaches," explains Hogan. Impact on Conception Hypothyroidism and getting pregnant don't always mix well. The condition can interfere with both fertilization and implantation, posing challenges to conception. Some complications include: Delays in natural conception for those quitting birth controlHeavy bleeding, leading to increased sick days and discomfortVaginal dryness, which can make conceiving difficult due to reduced natural lubricationLow testosterone levels in men, reducing sexual drive and sperm functionalityUnsuccessful egg attachment to the womb due to insufficient estrogen levelsWeak placenta formation Does Hypothyroidism Cause Infertility?In short, yes. But are you wondering how thyroid issues can cause infertility? When thyroxine levels are low and body functions are slower due to an underactive thyroid, the placenta can be compromised from implantation. Therefore, pregnancy may not take, even after an embryo is developed. So overall, reproductive wellness can be affected. » Find out how to recognize happy and healthy hormones with charting Impact on Pregnancy Even while pregnant, hypothyroidism can cause complications. Many of these extend past fertilization to the development of the embryo and the mother's health. Some risks include: Miscarriage, especially around the 12-week markPotentially compromised fetal brain developmentPreeclampsia (characterized by high blood pressure)AnemiaPostpartum hemorrhageMuscle pain and weaknessCongestive heart failureThyroid effects on the uterus, such as the placenta prematurely separating from the uterusHeightened anxiety "Despite the critical role that thyroid function plays in pregnancy, many people undergoing infertility treatment may not receive adequate education on the importance of these tests and why they're being done," says Hogan. "Hypothyroidism can affect not just physical health but also mood. This influence can extend to a child's development, implying a need for thyroid function evaluation if there are growth concerns." Treatments to Help Improve Reproductive Health With no definitive way to prevent hypothyroidism, early detection and management are key, particularly for individuals with a higher risk of thyroid problems due to a history of autoimmune diseases, radiation therapy in the neck, or certain medications. Hypothyroidism infertility treatments can be managed through bigger-picture measures that target the symptoms leading to conception troubles. Some approaches include: Thyroid Medications Any thyroid medication should be administered by a medical professional as each person's medical history can affect which medications are appropriate for them. Regular monitoring is important to ensure the correct dosage, avoid complications, and keep your healthcare provider informed of any side effects. Some side effects occur when the medication leads to an overactive thyroid (hyperthyroidism). These include: Rapid heart rateNervousnessIrritability "Despite potential side effects, maintaining appropriate thyroid hormone levels is important for the health of both the mother and baby," says Hogan. Dietary Changes Certain dietary changes can have potential benefits. For instance, adopting a plant-based diet can help with symptom alleviation as thyroid issues can exacerbate inflammatory responses in the body. However, it is important to keep in mind that dietary changes may not necessarily resolve hypothyroidism completely, but they can potentially help manage symptoms. Note: Regardless of the dietary approach, hypothyroidism should be managed and implemented under the guidance of a healthcare professional regularly. Food and Supplements Certain foods and supplements should be regulated due to their potential impact on thyroid function. Soy products and iron supplements can interfere with thyroid hormone absorption, particularly for those with an iodine deficiencyKelp and other seaweeds with high amounts of iodine (Tip: iodine intake should be moderate even if you have a deficiency)Certain vegetables—such as cauliflower, kale, and cabbage—contributing to goiter development when consumed in large quantities Emotional Support As thyroid hormones play a crucial role in mood regulation, achieving a balance is beneficial not only for physical health but also for emotional well-being. By managing hypothyroidism, particularly because of decreased mood regulation, anxiety levels can be decreased. This is especially helpful for women who have undergone infertility treatments and are now pregnant. Tip: "Women planning for pregnancy should be assessed for thyroid hormones and serum prolactin," advises Hogan. Untreated hypothyroidism during pregnancy can lead to various complications, including subfertility, fetal death, premature delivery, and spontaneous abortion. » Want to know more? Discover the connection between ovulation and mental well-being Take Charge of Your Fertility "There is no sure-fire way to prevent hypothyroidism. But if early signs of the condition are detected, measures can be taken to prevent the disease from progressing," says Hogan. With this condition having a direct impact on ovulation, metabolism, conception, and healthy pregnancies, bolstering your fertility health is crucial. This includes professional medical monitoring, hormone management, and dietary adjustments. But to start, you can better understand your body and how it reacts to hypothyroidism symptoms. With Tempdrop's hassle-free BBT monitoring armband and cycle charting app, you can learn your body's rhythms for more informed fertility planning.