Menstrual Thyroid Issues
Hello, Doctor! I was diagnosed with hyperthyroidism in February, which transitioned to hypothyroidism by April.
Recently, my treatment has been stabilizing, and my values are normal! The endocrinologist has advised me to have regular follow-ups for management.
However, I have not had my period since April, which has been over six months now.
Occasionally, I experience lower abdominal pain, back pain, and discharge, but there is no bleeding (previously, I would have back pain and lower abdominal pain before or during my period).
I have been considering seeing a gynecologist, but since I am still managing my hypothyroidism and need to take medication, I have not gone.
Additionally, last month, due to abdominal pain, I underwent an endoscopy and was diagnosed with gastroesophageal reflux disease (GERD), for which I am currently undergoing treatment and taking medication.
I also visited a traditional Chinese medicine practitioner for a persistent cough, who advised me to stop taking Western medicine and start with herbal medicine.
This has led me to postpone seeing a gynecologist, and I am unsure if I can manage so many conditions and medications simultaneously.
How should I space out my medication times? Can hypothyroidism cause amenorrhea, or could I possibly have a gynecological issue?
Miss Lin, 20~29 year old female. Ask Date: 2022/10/21
Dr. Cai Yonglong reply Obstetrics and Gynecology
Hypothyroidism is one of the common causes of amenorrhea, but it typically does not cause lower back pain, lower abdominal pain, or increased discharge.
It is advisable to consider the possibility of a gynecological infection and to seek a complete evaluation and treatment at a nearby obstetrics and gynecology clinic.
Reply Date: 2022/10/21
More Info
Thyroid issues, particularly hypothyroidism and hyperthyroidism, can significantly impact menstrual cycles and overall reproductive health. In your case, transitioning from hyperthyroidism to hypothyroidism can lead to various hormonal imbalances that may affect your menstrual regularity.
Hypothyroidism, characterized by insufficient thyroid hormone production, can lead to several symptoms, including fatigue, weight gain, and, notably, menstrual irregularities. Women with hypothyroidism often experience heavier, more prolonged menstrual periods, but it can also lead to amenorrhea, which is the absence of menstruation. The hormonal imbalance caused by thyroid dysfunction can disrupt the hypothalamic-pituitary-ovarian axis, which is crucial for regulating the menstrual cycle.
Given that you have not had a menstrual period for over six months, it is essential to consider the potential causes. While hypothyroidism is a likely contributor, other factors could also be at play, including stress, significant weight changes, or other underlying gynecological conditions. The abdominal pain and white discharge you mentioned could indicate other issues, such as ovarian cysts or endometriosis, which may require further evaluation by a gynecologist.
It is understandable that you have been hesitant to see a gynecologist due to your ongoing treatment for thyroid issues and gastroesophageal reflux disease (GERD). However, it is crucial to address your menstrual irregularities and any associated symptoms. Coordinating care between your endocrinologist and gynecologist can help ensure that all aspects of your health are managed effectively.
Regarding medication management, it is essential to communicate with your healthcare providers about all the medications you are taking. They can help you develop a schedule that minimizes interactions and maximizes the effectiveness of your treatments. For instance, certain medications may need to be taken at different times to avoid absorption issues or interactions.
In summary, hypothyroidism can indeed lead to menstrual irregularities, including amenorrhea. However, it is essential to rule out other potential causes through a thorough evaluation by a gynecologist. Coordinating your care and discussing your medication regimen with your healthcare providers will help ensure that you receive comprehensive treatment for all your health concerns. Regular follow-ups with your endocrinologist to monitor your thyroid function are also crucial, as optimal thyroid hormone levels can help restore menstrual regularity.
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