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Is There A Link Between Thyroid Disorders And PCOS?

Polycystic ovary syndrome (PCOS) and thyroid disorders are both endocrine disorders that involve hormonal imbalances.

Introduction

They are, however, two distinct conditions that can coexist in some women, and their interactions frequently influence each other. 
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Understanding The Link Between Thyroid Disorders And PCOS

The thyroid is a small gland in your neck that produces hormones called T3 and T4 that regulate how your body uses energy. As long as the thyroid is functioning properly, there will always be the appropriate amount of hormones in the blood to maintain metabolism. Once these hormones are depleted, new hormones will take their place.

The pituitary gland is in charge of the entire process. In the case of an excess or deficiency of thyroid hormones, it will try to compensate with its own hormone, thyroid stimulating hormone. 
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The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Hypothyroidism is a condition in which the thyroid gland produces insufficient thyroid hormones. Inadequate thyroid hormone levels in the body can cause fatigue, increased sensitivity to cold temperatures, and weight gain.

Hyperthyroidism, on the other hand, is a condition in which the thyroid gland produces an excess of thyroid hormones. As a result, the body expends energy too quickly, causing tiredness, rapid heartbeat, unintentional weight loss, and nervousness. 
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Thyroid disease is a very common condition. It affects approximately 20 million people in the United States. In Pakistan, the prevalence of hyperthyroidism and hypothyroidism is 5.1% and 4.1%, respectively<a href="#accordion">[8]</a>.

It can affect anyone, including infants, adolescents, the elderly, men, and women. It can be present at birth, especially hypothyroidism, and it can develop with age, particularly in women after menopause. A woman is 5-8 times more likely than a man to have it<a href="#accordion">[1]</a>. 
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PCOS is a condition in which the hormones that regulate your reproductive system are out of balance. The condition affects 4-18% of women of reproductive age worldwide. According to the NHS, 1 in every 10 women in the UK is affected. The ratio is much higher in Pakistan, where nearly 52% of women are affected<a href="#accordion">[7]</a>.

The most common hormonal imbalances seen in PCOS include: 
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<ul>
	<li>
	<h5>Elevated Androgens</h5>
	</li>
</ul>

Women with PCOS typically have higher levels of androgens (male hormones) than normal. This excess of androgens can cause acne, hirsutism (excessive hair growth), and male pattern baldness. 
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<ul>
	<li>
	<h5>Insulin Resistance</h5>
	</li>
</ul>

Many women with PCOS have insulin resistance, where their body&#39;s cells do not respond well to insulin, leading to higher insulin levels in the blood. This can contribute to weight gain, difficulty losing weight, and an increased risk of type 2 diabetes. 
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<ul>
	<li>
	<h5>Irregular Menstrual Cycles</h5>
	</li>
</ul>

The hormonal imbalances in PCOS can lead to irregular or absent menstrual cycles. Some women have infrequent periods, while others have very heavy or long periods. 
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<ul>
	<li>
	<h5>Increased Luteinizing Hormone (LH)</h5>
	</li>
</ul>

PCOS is associated with higher levels of LH than follicle-stimulating hormone (FSH). This imbalance interferes with normal ovulation. 
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<ul>
	<li>
	<h5>Lower Progesterone Levels</h5>
	</li>
</ul>

Women with PCOS may have lower levels of progesterone, a hormone that plays a crucial role in regulating the menstrual cycle. 
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According to research, PCOS is related to a high incidence of subclinical hypothyroidism, autoimmune thyroiditis, and goiters<a href="#accordion">[2]</a>.

Here are some reasons why PCOS and thyroid disorders may be related: 
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<ul>
	<li>Thyroid Disorders, such as an underactive or overactive thyroid, can sometimes cause changes in metabolism and other bodily functions. Thyroid disease symptoms can overlap with those of PCOS, making it critical for healthcare providers to accurately diagnose and differentiate the two conditions. It may also aggravate certain symptoms of PCOS, such as insulin resistance and weight gain. 
	&nbsp;</li>
	<li>Insulin Resistance, a condition in which the body&#39;s cells become less responsive to insulin, is another feature shared by both PCOS and some thyroid disorders. Women with thyroid disorders and PCOS frequently struggle with weight gain and other health issues because insulin resistance exacerbates the metabolic effects of the conditions. 
	&nbsp;</li>
	<li>PCOS And Thyroid Disease both have an impact on fertility. PCOS makes it difficult to conceive due to irregular ovulation. Besides, hormonal imbalances in thyroid disorders can increase the risk of miscarriage. 
	&nbsp;</li>
	<li>Autoimmune Conditions are more common in women with PCOS[3]. Some women with PCOS have autoimmune thyroid disorders, such as Hashimoto&#39;s thyroiditis or Graves&#39; disease. The immune system of the body attacks the thyroid gland in these conditions. 
	Even in the absence of overt thyroid dysfunction, the presence of thyroid antibodies may have implications for fertility and overall health in women with PCOS. 
	&nbsp;</li>
	<li>The Two Conditions share some risk factors, too. For instance, family history, genetic factors, obesity, insulin resistance, and inflammation all play a role in the development of both conditions. 
	&nbsp;</li>
</ul>

Almost all women with PCOS have hormonal imbalances. That is why it is critical for doctors to consider both possibilities when a patient has irregular periods, weight changes, or other related symptoms. It&#39;s essential to get a proper diagnosis and treatment from a healthcare professional to manage these conditions effectively. 
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Note: While there is a link between thyroid disorders and PCOS, they are separate conditions with different underlying causes. Yes, their interactions can have an impact on one another, resulting in overlapping symptoms and complications. However, each condition necessitates unique diagnostic testing and treatment strategies.

If you suspect you have PCOS or a thyroid disorder, it is critical to see a doctor for a thorough evaluation, an accurate diagnosis, and an appropriate treatment plan. They can perform the necessary tests and make treatment recommendations based on your specific health needs. 
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According to research, thyroid disorders occur more frequently in women with PCOS than those without<a href="#accordion">[4]</a>. PCOS is a lifelong condition, and that while treatment can help manage symptoms and reduce risks, it may not completely eliminate the condition. 
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<ul>
	<li>Treatments that address hormonal imbalances, particularly excess androgens and the LH/FSH ratio, can help regulate menstrual cycles. When menstruation becomes more regular, the likelihood of pregnancy increases for those who want it. 
	&nbsp;</li>
	<li>Treatment can help reduce the effects of excess androgens, such as acne, hirsutism, and male pattern baldness. Oral contraceptives and anti-androgen drugs may be prescribed for this purpose. 
	&nbsp;</li>
	<li>Combating insulin resistance is critical, especially for women with PCOS who are predisposed to type 2 diabetes. A healthy diet and regular exercise, as well as medications such as metformin, can help improve insulin sensitivity<a href="#accordion">[4]</a>. 
	&nbsp;</li>
	<li>In rare instances, surgical intervention is necessary to remove the thyroid gland<a href="#accordion">[5]</a>. 
	&nbsp;</li>
</ul>

Note: Treatment approaches may differ depending on individual symptoms, goals, and medical history. Therefore, it&#39;s crucial for women with PCOS to work closely with healthcare professionals to develop a personalized treatment plan that addresses their specific needs and concerns. 
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The primary focus of PCOS treatment is to restore hormonal balance and improve symptoms. Doctors may prescribe hormonal contraception, hormone replacement therapy, or metformin for PCOS.

Lifestyle changes, such as adopting a healthy diet and engaging in regular physical activity, can also improve insulin sensitivity and help manage insulin resistance. Women with PCOS should be especially careful with their iodine intake if they are at risk of or have been diagnosed with hypothyroidism, because iodine is necessary for the production of thyroid hormones<a href="#accordion">[6]</a>. Metformin, for example, may be prescribed to improve insulin sensitivity. 
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Note: PCOS is a complex condition, and treatment may not completely eliminate all aspects of hormonal imbalances in all cases. It may take time to find the most suitable treatment approach for an individual, and treatment plans may need to be adjusted based on the response and specific health needs of each person. 
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Conclusion

Thyroid disorders and PCOS have a complex and multifaceted relationship, involving hormonal imbalances and shared underlying factors. While there is a link between PCOS and thyroid disorders, not all PCOS women will have thyroid problems, and vice versa.

Women with PCOS should be screened for thyroid disorders by their healthcare providers. Likewise, women with thyroid disorders should be screened for PCOS. Especially if symptoms overlap or if one condition is suspected of influencing the other.

Because the two are so similar, it is easy to overlook one or the other. Increasing awareness among young girls and even older women can help them understand the similarities and differences between PCOS and thyroid disorders. 
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Key Takeaways

<ul>
	<li>Thyroid dysfunction, such as hypothyroidism or hyperthyroidism, is common in women with PCOS.</li>
	<li>Thyroid disorders and PCOS both involve hormonal imbalances.</li>
	<li>In hypothyroidism, or underactive thyroid, there is a decrease in thyroid hormone production.</li>
	<li>In PCOS, there is an imbalance in sex hormones, specifically increased levels of androgens and/or insulin.</li>
	<li>Both PCOS and hypothyroidism are also associated with insulin resistance.</li>
	<li>Self-diagnosis can be inaccurate and dangerous. It is essential to seek professional medical advice if you want to understand your health situation and get the care you need.</li>
	<li>The symptoms of PCOS can be improved, and the risks to your long-term health can be decreased, with the help of medications, lifestyle modifications, and other treatments.</li>
	<li>Increasing awareness among young girls and even older women can help them understand the similarities and differences between PCOS and thyroid disorders. 
	&nbsp;</li>
</ul>

[1] Thyroid disease: Causes, symptoms, risk factors, testing &amp; treatment. Cleveland Clinic.

[2] Diagnosing PCOS: The link between hypothyroidism and PCOS. Empowered Women’s Health.

[3] Nicole Galan R. PCOS and hypothyroidism: Is there a link? Verywell Health.

[4] PCOS and hyperthyroidism: 9 things to know. Healthline.

[5] PCOS and hyperthyroidism: The link, symptoms, diagnosis, and more. Medical News Today.

[6] Angela Grassi M. 5 things women with PCOS should know about hypothryoidism. Verywell Health.

[7] Azhar A, Abid F, Rehman R. Polycystic Ovary Syndrome, Subfertility and Vitamin D Deficiency. J Coll Physicians Surg Pak. 2020;30(5):545-546. doi:10.29271/jcpsp.2020.05.545

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