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Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism.

Muderris II, Boztosun A, Oner G, Bayram F - Ann Saudi Med (2011 Mar-Apr)

Bottom Line: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation.Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries.A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey.

ABSTRACT

Background and objectives: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance.

Design and setting: Open, prospective study of women admitted to university gynecology clinic.

Patients and methods: The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved.

Results: Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone.

Conclusion: Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.

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Ovarian volume (mean [SD]) in patients with primary hypothyroidism before and after treatment with L-thyroxine compared with that in controls.
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Figure 1: Ovarian volume (mean [SD]) in patients with primary hypothyroidism before and after treatment with L-thyroxine compared with that in controls.

Mentions: Patients with hypothyroidism and polycystic ovaries had significantly higher basal DHEAS and free T but lower A levels when compared with those with normal-appearing ovaries (P<.05). Serum total T concentrations were significantly higher in hypothyroid patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total and free T levels. The ovarian volumes of patients with hypothyroidism (with or without polycystic ovaries) were significantly greater when compared with controls (P<.05, Figure 1). Basal ovarian volumes within the study population were similar, although the slightly larger size of the left ovary in those with polycystic ovaries was statistically significant (P<.05). There was no association between serum pretreatment TSH levels and ovarian volumes (P>.05; the Pearson correlation coefficient for the left and right ovary was 0.256 and 0.07, respectively). Ovarian volumes of hypothyroid patients with or without polycystic ovaries decreased significantly during hormone replacement therapy and became comparable with those of controls (P<.05, Figure 1). Of the 22 patients with mild hypothyroidism, 10 had polycystic ovaries before thyroxine therapy. In all these patients, the polycystic appearance of the ovaries regressed after euthyroidism was achieved for at least 3 months.


Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism.

Muderris II, Boztosun A, Oner G, Bayram F - Ann Saudi Med (2011 Mar-Apr)

Ovarian volume (mean [SD]) in patients with primary hypothyroidism before and after treatment with L-thyroxine compared with that in controls.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3102473&req=5

Figure 1: Ovarian volume (mean [SD]) in patients with primary hypothyroidism before and after treatment with L-thyroxine compared with that in controls.
Mentions: Patients with hypothyroidism and polycystic ovaries had significantly higher basal DHEAS and free T but lower A levels when compared with those with normal-appearing ovaries (P<.05). Serum total T concentrations were significantly higher in hypothyroid patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total and free T levels. The ovarian volumes of patients with hypothyroidism (with or without polycystic ovaries) were significantly greater when compared with controls (P<.05, Figure 1). Basal ovarian volumes within the study population were similar, although the slightly larger size of the left ovary in those with polycystic ovaries was statistically significant (P<.05). There was no association between serum pretreatment TSH levels and ovarian volumes (P>.05; the Pearson correlation coefficient for the left and right ovary was 0.256 and 0.07, respectively). Ovarian volumes of hypothyroid patients with or without polycystic ovaries decreased significantly during hormone replacement therapy and became comparable with those of controls (P<.05, Figure 1). Of the 22 patients with mild hypothyroidism, 10 had polycystic ovaries before thyroxine therapy. In all these patients, the polycystic appearance of the ovaries regressed after euthyroidism was achieved for at least 3 months.

Bottom Line: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation.Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries.A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey.

ABSTRACT

Background and objectives: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance.

Design and setting: Open, prospective study of women admitted to university gynecology clinic.

Patients and methods: The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved.

Results: Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone.

Conclusion: Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.

Show MeSH
Related in: MedlinePlus