Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature

Abstract

BackgroundPublished data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing.ObjectiveTo comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities.MethodsNine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion.ResultsPCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population.ConclusionPCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.

Hypothyroidism and Its Impact on Menstrual Irregularities in Reproductive-Age Women: A Comprehensive Analysis at a Tertiary Care Center

“…Similarly, the comprehensive review by Fan et al (2023) [16] discusses the role of thyroid dysfunction in conditions such as polycystic ovary syndrome (PCOS), further emphasizing the interconnectedness of thyroid and reproductive health. Palomba et al (2023) provide a detailed narrative review that underscores the co-occurrence of thyroid disorders and PCOS, highlighting the complex interplay between these endocrine conditions [17].…”

The role of the thyroid in polycystic ovary syndrome

“…Increasing evidence shows that PCOS is related to the increased incidence rate of thyroid diseases, such as autoimmune thyroiditis (AIT), and subclinical hypothyroidism (SCH) ( 5 – 7 ). Palomba et al, have made a comprehensive narrative review on PCOS and thyroid disorder recently ( 8 ). This review provides us with a comprehensive understanding of the current research between thyroid and PCOS.…”

Thyroid disorders in polycystic ovary syndrome patients

“…В исследованиях на животных было показано, что все рецепторы, задействованные в работе гипоталамо-гипофизарно-тиреоидной системы, включая тиреотропин-рилизинг гормон, тиреотропный гормон (ТТГ) и тиреоидные гормоны, присутствуют в матке макак [3]. У женщин с гипертиреозом отмечают более высокие уровни глобулина, связывающего половые гормоны, эстрадиола, тестостерона, андростендиона, фолликулостимулирующего (ФСГ) и лютеинизирующего (ЛГ) гормонов в сравнении с их сверстницами с эутиреозом [4]. Кроме того, гипертиреоз ассоциирован с нерегулярными менструальными циклами [5].…”

“…Концентрация пролактина при этом может быть увеличена в связи с повышением секреции тиреотропин-рилизинг-гормона. Уровни ФСГ и ЛГ были нормальными [4,5]. Гипотиреоз может быть ассоциирован с формированием кист яичника [6].…”