What Are the Effects of Thyroid Problems in Women?

The thyroid is an H-shaped or butterfly-shaped organ located in the front of the neck. It is about 2 inches long, with the horizontal part of the H placed across and in front of the trachea and the vertical part of the H or the wings extending along the side of the trachea. 

The thyroid is part of the endocrine system and controlled by the pituitary gland. The pituitary gland regulates the thyroid gland to release hormones through the thyroid-stimulating hormone (TSH).

Women are more prone to thyroid disease than men due to hormonal fluctuations, and about 1 in 8 women will have a thyroid problem in their lifetime.

Thyroid diseases that affect women include:

• Hyperthyroidism (overactive thyroid)
• Hypothyroidism (underactive thyroid)
• Goiter
• Thyroiditis, especially postpartum thyroiditis
• Thyroid nodules
• Thyroid cancer

Overstimulation of TSH hormones or local dysregulation in the production of thyroid hormones can lead to thyroid nodules and thyroid cancers, which need to be surgically removed.

Thyroid disease can develop at any age, but the risk is higher in women after menopause. Other risk factors include:

• Age over 60
• Family history of thyroid disease
• Medications containing high iodine (such as amiodarone)
• Immune conditions such as pernicious anemia, type I diabetes, lupus, rheumatoid arthritis, and Sjögren’s syndrome
• Previous treatment for a thyroid condition or cancer (thyroid surgery)

Symptoms of thyroid disease are often very similar to those of other conditions, making diagnosis difficult. Symptoms of thyroid disease can be divided into two groups: hyperthyroidism and hypothyroidism.

Symptoms of hyperthyroidism may include:

• Anxiety and irritability
• Weight loss
• Sleep disturbances
• Neck mass
• Muscle weakness
• Tremors
• Irregular menstrual periods or amenorrhea
• Intolerance to heat

Symptoms of hypothyroidism may include:

• Fatigue
• Weight gain
• Frequent and heavy menstrual bleeding
• Dry hair
• Hair loss
• Hoarse voice
• Intolerance to cold

The goal of treatment is to stabilize thyroid hormone levels through medications or surgical procedures.

Treatment options for hyperthyroidism may include:

• Antithyroid drugs: Medications such as methimazole and propylthiouracil stop the thyroid from producing hormones.
• Radioactive iodine: Radiation therapy destroys thyroid gland cells, thus preventing the production of thyroid hormones.
• Beta-blockers: These medications help control symptoms without affecting thyroid hormone levels.
• Surgery: Surgery is considered a permanent form of treatment in which the thyroid gland is surgically removed (thyroidectomy). The remaining part of the thyroid thus produces smaller amounts of thyroid hormones. However, thyroid replacement hormones need to be taken to maintain the hormone levels.

Treatment for hypothyroidism includes:

• Thyroid replacement medication: A synthetic drug that mimics the natural thyroid hormones is used to restore normal levels in the body. A commonly used drug is called levothyroxine. Long-term use of this medication can help control thyroid hormone levels and reduce most symptoms of hypothyroidism.

Treatment for postpartum thyroiditis depends on the phase of the disease. The initial phase of hyperthyroidism can be treated with the goal of reducing heart rate and relieving other symptoms such as anxiety, diarrhea, and fever. In most cases, thyroid hormones return to normal within 12-18 months of symptom onset. A history of postpartum thyroiditis increases the risk of developing permanent hypothyroidism within 5-10 years.