Influence of hormonal contraception on thyroid gland diseases

Czech version

Authors: J. Bednářová ¹; V. Zamrazil ²
Authors‘ workplace: Katedra antropologie Přírodovědecké fakulty Univerzity Karlovy, Praha Vedoucí: doc. Mgr. Vladimír Sládek, Ph. D. ¹; Endokrinologický ústav, Praha Ředitel: doc. MUDr. Vojtěch Hainer, CSc. ²
Published in: Prakt. Lék. 2009; 89(5): 244-246
Category: Of different specialties

Overview

In this study, 336 patients from the endocrinology outpatient department aged 15 - 82 and being treated for a thyroid gland disease for different lengths of time anonymously answered a questionnaire. The aim was to find out whether hormonal contraception might influence the occurrence of thyroid gland disorders. A questionnaire with open and reserved questions was used. For analysis of the results, the currently used medical classification of thyroid gland diseases was taken into account – goitres, thyroiditis, hypothyroidism, hyperthyroidism, tumour and surgery. Since the research also revealed that almost a fifth of the women did not know what disorder they actually suffered from, a further category of “I don’t know” had to be included in the research results. Our preliminary results seem to indicate that the use of hormonal contraception increases the risk of developing autoimmune thyroid diseases (autoimmune thyroiditis and subsequent hypothyroidism). The reason why there is a statistically significant lower frequency of thyroid gland surgery in women taking hormonal contraception remains unclear. A further, more detailed study including a larger sample of patients is necessary.

Key words:
hormonal contraception, diseases thyroid gland.

Sources

1. Amino, N., Hidaka, Y. Chronic (Hashimotos´) Thyroiditis. In: De Groot L. J., Jameson J. L. Endocrinology. 5th edition. Philadelphia: Elsevier Saunders 2006, p. 2055-2068.

2. Bařinová, V., Zamrazil, V. Hypotyreóza - diagnóza a léčba. Postgraduální medicína, 2003, 5, s. 189-195.

3. Bednářová, J., Zamrazil, V. Vliv opakovaných zánětů horních cest dýchacích na výskyt onemocnění štítné žlázy – srovnání s obecnou populací. Prakt. lék. 2007, 87, s. 724-726.

4. Blahoš, J., Zamrazil, V. Endokrinologie – interdisciplinární obor. Praha: Triton 2006.

5. De Groot, L.J., Jameson, J.L. Endokrinology 4, Philadelphia: W. B. Saunders Comp 2001, p. 1884-1902.

6. Frank, P., Kay, C.R. Incidence of thyroid disease associated with oral contraceptioves. New Engl. J. Med. 2003, 349, p. 1433-1450

7. Inal, M.M., Yildirim, Y., Ertopcu, K. et al. Effect of the subdermal contraceptive etonogestrel implant on biochemical and hormonal parameters. Eur. J. Contracept. Reoprod. Health Care, 2008, 13, p. 238-242.

8. Jaffe, R.B., Barberi, R.L. Reproductive Endocrinology. Philadelphia: Saunders 1999.

9. Kaňová, N. Onemocnění štítné žlázy a příštípných tělísek v graviditě. In: Stárka a kol. Pokroky v endokrinologii, Praha Maxdorf 2007, s. 388-398.

10. Knudson, N. et al Low goitre prevalence among users of oral contraception in a population sample of 3712 women. Clin. Endocrinol. 2002, 57, p.71-76.

11. Límanová, Z. Štítná žláza – Trendy soudobé endokrinologie 2. Praha: Galén 2006.

12. Markalous, B., Gregorová, M. Nemoci štítné žlázy. Praha: Triton 2004.

13. Massondi, M.S. et al Prevalence of thyroid antibodies among healhty women. Findings from the thyroid study in healthly women. Clin. Endocrinol. 1995, 5, p. 229-233.

14. Němec, J., Zamrazil, V. Štítná žláza. Praha: Maxdorf 2005, s. 81-108.

15. Picchi, P. et al. Reproductive history, contraceptives and cigarete smoke as risk factors for cancer of the thyroid in women. Minerva Endocrinol, 2001.

16. Prummel, M.F. et al. The enviroment and autoimmune thyroid disease. Europ J Endocrinol. 2004.

17. Sanger, N. et al. Effects of oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg diehogest on thyroid hormones… Contraception 2008.

18. Stárka, L. a kol. Štítná žláza. Pokroky v endokrinologii. Praha: Maxdorf 2007, s. 271-398.

19. Stárka, L., Zamrazil, V. Základy klinické endokrinologie Praha: Maxdorf 2005, s. 27-41.

20. Šterzl, I. Přehledná imunoendokrinologie. Praha: Maxdorf 2006.

21. Vestergaard, P. et al Smoking as a risk factor for Graves disease, toxic nodular goiter and autoimmune hypothyroidism. Thyroid 2002, 12, p. 69-75.

22. Zamrazil, V. Onemocnění štítné žlázy v ordinaci praktického lékaře. Prakt. lék., 2007, 87, s. 142-149.