How Thyroid Surgery Affects Menstrual Irregularities: What to Know

Irregular menstruation?

Hello, doctor.
I underwent a total thyroidectomy on December 1, 2020.
My menstrual cycles in December, January, and February were normal, but in March, they became irregular.
The flow was very light, enough to use just a panty liner, and lasted only 2-3 days with a very dark brown color.
Can the thyroid affect menstrual cycles? Is it normal for this to happen three months after the surgery? I am not pregnant.

Niu Niu, 30~39 year old female. Ask Date: 2021/04/04

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
It can affect menstruation.
2.
The occurrence varies from person to person, generally within 6 months.

Reply Date: 2021/04/04

More Info

Thyroid surgery, particularly total thyroidectomy, can have significant effects on various bodily functions, including menstrual cycles. The thyroid gland plays a crucial role in regulating metabolism and hormonal balance in the body, and its removal can lead to changes in hormone levels that may affect menstrual regularity.

After a total thyroidectomy, patients often require lifelong thyroid hormone replacement therapy, typically in the form of levothyroxine (Eltroxin). This medication aims to normalize thyroid hormone levels in the body, which are essential for maintaining metabolic processes, including those that regulate the menstrual cycle. However, achieving the right dosage can take time, and it is not uncommon for patients to experience fluctuations in their hormone levels during the adjustment period.

In your case, it is noteworthy that your menstrual cycle was normal for the first two months post-surgery but then became irregular in March. This change could be attributed to several factors:
1. Hormonal Imbalance: After thyroid surgery, the body may take time to adjust to the new hormonal environment. If your thyroid hormone levels are not adequately balanced, it can lead to irregularities in your menstrual cycle. Low levels of thyroid hormones can result in hypothyroidism, which is known to cause heavier, irregular periods, while excessive levels can lead to lighter or missed periods.

2. Adjustment Period: The first few months after surgery can be a period of adjustment for your body. It is possible for menstrual irregularities to occur as your body adapts to the absence of the thyroid gland and the introduction of synthetic hormones. This adjustment can sometimes take several months, and it is not unusual for menstrual patterns to fluctuate during this time.

3. Other Factors: Stress, changes in weight, diet, and lifestyle can also impact menstrual cycles. If you have experienced any significant changes in these areas since your surgery, they could contribute to the irregularities you are observing.

4. Underlying Conditions: It is also essential to consider other potential underlying conditions that could affect your menstrual cycle, such as polycystic ovary syndrome (PCOS) or other hormonal disorders. If you have a history of such conditions, they may also play a role in your current symptoms.

Given that you are experiencing a significant change in your menstrual cycle, it is advisable to consult with your healthcare provider. They may recommend monitoring your thyroid hormone levels (TSH, Free T4) to ensure that your medication dosage is appropriate. Additionally, they may suggest further evaluation to rule out other potential causes of menstrual irregularities.

In summary, while it is not uncommon for menstrual cycles to be affected after thyroid surgery, especially during the adjustment period, it is crucial to ensure that your thyroid hormone levels are adequately managed. Regular follow-ups with your healthcare provider can help address any concerns and ensure that your hormone levels remain stable, which is essential for overall health and well-being.

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