Thyroid

A Complete Guide of Thyroid in Women

Parul Dube

November 21, 2022

One in eight women tends to develop a thyroid disorder at some point in their lives. These disorders can affect anyone. However, the risk for women is five to ten times higher than for men. Detailed epidemiological surveys show that women from developing countries are at risk of undiagnosed thyroid problems. They are widespread in women during and after menopause when continuous hormonal changes occur. One study shows that adult postmenopausal females are vulnerable to thyroid dysfunction, particularly hyperthyroidism. Another reason is iodine deficiency, which plays a role in thyroid disorders worldwide irrespective of gender.

How a thyroid disorder affects a woman’s body depends on their life stage. While these abnormalities during puberty impact the menstrual cycle, the focus later shifts to fertility during middle age. In pregnant women, thyroid problems trigger a set of conditions like premature labour, poor neurodevelopment, preeclampsia, and postpartum haemorrhage. Proper medical treatment and monitoring can manage the most lifelong diseases. First, however, women need to be aware of the risk factors, symptoms, and complications of thyroid problems and seek help. After all, timely intervention ensures the best for you.

Do I have Thyroid: The Early Signs 

Women often end up ignoring the symptoms of thyroid problems. For example, the postpartum thyroid signs are mistaken for the childbirth recovery signs. In addition, symptoms depend on the phase of the condition. For the most part, the signs of these diseases often mimic the symptoms of other medical conditions. Thus, making it difficult to understand if it’s thyroid or something else.

Experiencing anxieties, weight fluctuations, muscle weakness, feeling tremulous, and fatigue may occur during the initial phase. 

There are two primary thyroid conditions: hypothyroidism and hyperthyroidism. Here are the early signs for both conditions.

The signs of hypothyroidism are:

  • Weight gain
  • Loss of concentration or forgetfulness
  • Intolerance to cold
  • Hoarse voice
  • Heavy flow during menstruations
  • Dry skin
  • Thinning hair
  • Constipation
  • Muscle weakness

The signs of hyperthyroidism are:

  • Weight loss
  • Nervousness and irritability
  • Sleeping troubles or insomnia
  • Irregular menstrual cycle
  • Increased sensitivity towards heat
  • Eye irritation or vision problems
  • Brittle hair
  • Neck swelling
  • Tremors
  • Frequent bowel movements

What Causes Thyroid in Women?

Iodine Deficiency

Low iodine in diet impacts the ability of the thyroid gland to function and produce hormones. Without consuming an adequate amount of iodine, the gland becomes enlarged. It leads to a condition called goitre, a common issue among women. In addition, the body fails to synthesise enough thyroid hormone in the absence of iodine.

Most women with goitre experience choking when they lie down and may experience difficulty swallowing and breathing. If you have any noticeable neck swelling, it’s time to get some diagnostic tests done. The human body does not produce iodine on its own. Thus, it’s vital to take them through diet and, if needed, through supplements. One can start by taking iodine rich multivitamins and using iodised table salt.

Graves’ Disease

Graves’ disease is an autoimmune condition where the immune system attacks its cells. It often leads to an overactive thyroid gland or hyperthyroidism. It occurs due to the production of too much thyroid hormone. Women over the age of 20 might experience these problems due to Graves’ disease. It is genetic and can pass down through generations.

Diabetes

Studies ascertain the close association between thyroid and diabetes. More than 20% of women with type 1 diabetes have thyroid problems. While most middle-aged women with these issues also have type 2 diabetes. Thus, one finds close linkages with the thyroid, irrespective of type 1 or 2 diabetes. Since type 1 diabetes is an autoimmune condition, it is more likely to trigger another autoimmune disease such as Graves’ disease. It, in turn, causes thyroid problems. Women with type 2 diabetes are more likely to develop thyroid disease. However, the risk is lower than those who have type 1 diabetes. Regular testing is essential for diabetic women to check for possible thyroid issues.

Postpartum Thyroiditis 

Postpartum thyroiditis is a common factor of thyroid issues after giving birth. It arises from the thyroid inflammation following the delivery of the baby. After getting inflamed, it emits excessive quantities of these hormones, leading to hyperthyroidism. This phase is often short-lived and mild. Once this stage passes, women either show complete recovery or sometimes have thyroid damage. However, if the damage sustains, it leads to underactive thyroid or hypothyroidism. However, only a tiny percentage of women suffer from it.

Menopause

Menopause can result in a significant hormonal shift in women’s bodies. And to make it even harder, menopause stifles the thyroid hormone balance. Specifically, varying oestrogen levels negatively impact thyroid function. Moreover, the rate of iodine absorption also falls during menopause. It further increases the likelihood of contracting thyroid diseases.

Too much oestrogen in the body can stimulate thyroid gland growth, becoming enlarged, also called goitre. It also brings down thyroid hormone production, making the gland inadequate for the body. It gradually triggers the symptoms of hypothyroidism. One needs to see if thyroid signs and symptoms often magnify when accompanied by menopause.

Hashimoto’s Thyroiditis

Existing medical conditions often cause thyroid problems. One such case is Hashimoto’s thyroiditis, an autoimmune disorder where the body’s immune system attacks the thyroid gland. It causes it to become underactive. Women with thyroid problems induced by Hashimoto’s thyroiditis find it challenging to conceive. Moreover, women are more likely to get this condition than men. The female to male ratio for Hashimoto’s thyroiditis is 8:1. It also affects women differently when compared to men.

Thyroid in Women: Adverse Effects

Effect on Menstrual Cycle

Problems with the menstrual cycle are quite common during thyroid diseases. Periods can either be lighter or heavier than usual. Thyroid problems make periods abnormally irregular and delayed. In some women with thyroid, the monthly cycle may occur earlier than expected. In addition, fluctuations in thyroid hormone affect puberty by triggering a condition called amenorrhea, where there’s a complete absence of periods. Severe hypothyroidism can even cause a woman to miss at least three menstrual cycles.

Effect on Pregnancy

Women with thyroid problems have some trouble becoming pregnant. Since thyroid hormones are directly involved in reproduction, any drop in its levels contributes to infertility. For instance, an irregular menstrual cycle during Hashimoto’s thyroiditis makes it harder for women to get pregnant. It is because ovulation or release of the egg is necessary for fertilisation. If that’s not happening, there’s no chance of natural pregnancy. Moreover, thyroid problems increase the risk of ovarian cyst development.

Symptoms of a normal pregnancy often aggravate if the mother has an existing thyroid condition. For example, a pregnant woman with thyroid disorder has more severe morning sickness than the one without any abnormalities. These problems have a powerful impact during pregnancy and postpartum. It can even harm the foetus. Thyroid diseases can cause postpartum haemorrhage, stillbirth, preterm delivery, and miscarriages. 

Effect on Digestive System

A healthy thyroid is deemed necessary for digestive health. Thus, any problems regarding the thyroid play a role in specific digestive woes. For example, women with severe hyperthyroidism have reported frequent bowel movements and moderate diarrhoea. In addition, it leads to poor nutrient absorption.

Additionally, hypothyroidism links to small intestinal bacterial overgrowth or SIBO. It is marked by abnormal bacterial growth in the small intestine, leading to abdominal discomfort, stomach pain, bloating, and flatulence.

Effect on Ear and Throat

Although rare, thyroid diseases can cause pain in the throat, jaw, and ear region. Throat discomfort is widespread. It interferes with daily routines like swallowing, breathing, and talking. The pain from a severely inflamed thyroid begins in the neck and slowly spreads upwards, ultimately reaching the ears. It gradually grows into a chronic cough, wheezing, and breathing difficulties.

Effect on Sexual Health

Women with thyroid problems are prone to sexual dysfunction. They can experience a reduced drive and desire. Around 46% of women have sexual dysfunction after being diagnosed with thyroid. An underactive thyroid contributes to poor sexual function and altered sex hormone levels. Even though the condition is reversible, it can take some time to show satisfying results.

Thyroid in Women: Preventive Measures 

As with many diseases, prevention is always better than cure. So here’s how to keep the thyroid gland on track and prevent its malfunction:

Thyroid Friendly Diet

Diet poor in iodine is the apparent culprit behind most thyroid conditions. So switch to iodised table salts and supplemented foods. However, do not take iodine pills unless instructed by a qualified medical professional. Instead, boost the selenium minerals intake to fight off the anti-thyroid antibodies. A study shows that selenium has effective antioxidants to combat thyroid autoimmunity. Brazil nuts are a good source of selenium.

Following a Mediterranean diet is highly recommended to avoid thyroid diseases. Aiming for four servings of fruit, five servings of veggies, fatty fish, and plenty of lean proteins helps prevent thyroid disease. In addition, to keep any potential inflammation in check, one can include healthy fats. Fie example, avocados, nut butter, coconut oil, sunflower oil, and extra-virgin olive oil are good for health.

Avoid Soy and Processed Foods

If you’re at an increased risk for thyroid problems, it’s best to avoid soy and its products, processed foods, and gluten. Limiting the soy intake can help to prevent any unwanted alterations in hormone production. Only a minority of women are at risk for thyroid by taking too many of these products. However, women who eat two servings a day are at higher risk than those who don’t eat soy. Thus, it would be better to avoid or limit its intake.

Thyroid disorders are easy to manage by restricting processed foods. Foods with added sugars, preservatives, dyes, and trans fat trigger inflammation. It can mainly cause autoimmune flare-ups, making you vulnerable to thyroid disorders.

Avoid Stress

Your overall stress levels play a significant role in thyroid gland function. Therefore, managing it is an added advantage to your physical and mental health. It would help if you avoided an unwanted interplay of stress hormones and thyroid hormones. Those under chronic stress simultaneously affect the thyroid, increasing the chances of related diseases. Thus, try to relax as much as you can.

Avoid Smoking

Studies say that cigarette smoking has a cause-and-effect relationship with thyroid problems. In women, smoking often leads to these issues and complications with fertility. Moreover, the chemical thiocyanate in smoke interferes with normal thyroid function. Non-smokers are less likely to have thyroid dysfunction unless it’s genetic.

Regular Health Checkups

There is no guarantee that the preventive measures can work for you, especially if there’s a family history of thyroid diseases. However, it is essential to have regular checkups and test the thyroid hormone levels. Also, talk to your doctor if you think you have an autoimmune disease. Due to the genetic composition, one autoimmune disease leads to another. It increases the risk of a thyroid condition. Thus, it is necessary to have a monthly checkup to be prepared. 

Conclusion

Thyroid disease is a global health problem with a higher prevalence among women. It also affects women differently than men. For example, untreated or undiagnosed thyroid disease can cause early menopause.

It occurs due to abnormalities in the thyroid gland. One can divide it into two- mainly underactive or overactive. Furthermore, thyroid problems in women often come with other medical conditions. It includes irregular menstrual cycles, poor fertility, sexual dysfunction, and very light or heavy periods. Women are also prone to partial to extensive hair loss.

You can reverse many of the effects of thyroid diseases with proper treatment. Within a year of starting the treatment, one shows improved chances of getting pregnant. It’s worth noting that it’s also possible to prevent these problems from happening in the first place. Taking preventive measures is essential to reduce the risk of further complications such as infertility and poor quality of life. Keep the consumption of soy products in limit. Be wary of processed foods with added sugars and preservatives. Instead, add more fruits, vegetables, lean protein, and healthy fats.

Frequently Asked Questions (FAQs)

Q. What are early warning signs of thyroid problems?

A. Most people don’t have any symptoms during the early stages. However, a swollen neck or enlarged thyroid is often the first sign. Other warning signs include weight gain or weight loss, irregular menstrual periods, constipation, and heightened sensitivity towards heat.

Q. Does thyroid affect periods?

A. Yes, thyroid problems change the menstrual cycle. It makes the periods either heavier or lighter. In some cases, periods become less regular and may even stop altogether. Moreover, too little thyroid in the body causes an absence of three menstrual cycles or more.

Q. Can a woman with thyroid problems get pregnant?

A. Women with thyroid problems can get pregnant. However, there will be difficulties in conceiving. A successful and healthy pregnancy requires a normal thyroid gland. A woman with an over or underactive thyroid faces fertility problems, absence of regular ovulation, preeclampsia, postpartum bleeding, and miscarriage risk. 

Q. What age do thyroid problems start?

A. Thyroid problems can start at any age, but the risk develops as women get older. The prevalence of thyroid disease onset has been noted mostly in women aged 20 to 30. It is also common during the 50s or the menopause period. However, genetic conditions like hypothyroidism can be present at birth.

Q. Can thyroid cause throat and ear pain?

A. Yes, an inflamed thyroid is responsible for causing throat and ear pain. The pain usually begins in the throat region and later spreads to the ear. It is rare to experience ear pain from thyroid problems, but throat pain is common.

Q. Does thyroid cause coughing?

A. Thyroid disease can irritate the trachea, causing the person to experience persistent cough. In the case of severe inflammation, the vocal cords can pressurise. It leads to dry and painful coughs.

Q. Is thyroid disease curable?

A. Yes, you can cure thyroid diseases. However, the recovery period and treatment method depend on the severity and type of infection. Most cases are curable with medications and lifestyle changes. However, some severe conditions might require radioactive iodine treatment and surgery.

Q. Does thyroid cause stomach pain?

A. Thyroid disorders often affect gut health, leading to gastric distress such as stomach pain, abdominal discomfort, bloating, and flatulence. It also results in bacterial overgrowth within the small intestine leading to it. Severe thyroid can cause persistent stomach pain accompanied by nausea and moderate diarrhoea.

About the Author

Parul holds a Masters of Medical Science in Public Health Nutrition from the University of Glasgow, Scotland, and has worked across the globe from the U.K to New Zealand (NZ) gaining her License with the Health Professionals Council (HPC, UK) and the NZ Nutrition Council. From being a Gold medalist in Clinical Nutrition to being awarded an internship with World Health Organisation (WHO, Cairo, Egypt) and Contracts with CDC Parul has had a wide spectrum of work experiences. She is very passionate about Nutrition and Fitness and holds strong to her guiding mantras ‘ Move more’ and ‘Eat Food that your grandmother can recognize’!


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