Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature
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.MethodsNi...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1251866/full |
| _version_ | 1797744569107873792 |
|---|---|
| author | Stefano Palomba Carla Colombo Carla Colombo Andrea Busnelli Andrea Busnelli Donatella Caserta Giovanni Vitale Giovanni Vitale |
| author_facet | Stefano Palomba Carla Colombo Carla Colombo Andrea Busnelli Andrea Busnelli Donatella Caserta Giovanni Vitale Giovanni Vitale |
| author_sort | Stefano Palomba |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T15:11:29Z |
| format | Article |
| id | doaj.art-c24c590e0a3a4e68b4a53a3f012ae187 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T15:11:29Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-c24c590e0a3a4e68b4a53a3f012ae1872023-08-11T17:46:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-08-011410.3389/fendo.2023.12518661251866Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literatureStefano Palomba0Carla Colombo1Carla Colombo2Andrea Busnelli3Andrea Busnelli4Donatella Caserta5Giovanni Vitale6Giovanni Vitale7Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, ItalyDivision of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Milan, ItalyDivision of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, ItalyDepartment of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Milan, ItalyLaboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, ItalyBackgroundPublished 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.https://www.frontiersin.org/articles/10.3389/fendo.2023.1251866/fullendocrine diseaseinfertilitypolycystic ovary syndromePCOSreviewthyroid |
| spellingShingle | Stefano Palomba Carla Colombo Carla Colombo Andrea Busnelli Andrea Busnelli Donatella Caserta Giovanni Vitale Giovanni Vitale Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature Frontiers in Endocrinology endocrine disease infertility polycystic ovary syndrome PCOS review thyroid |
| title | Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature |
| title_full | Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature |
| title_fullStr | Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature |
| title_full_unstemmed | Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature |
| title_short | Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature |
| title_sort | polycystic ovary syndrome and thyroid disorder a comprehensive narrative review of the literature |
| topic | endocrine disease infertility polycystic ovary syndrome PCOS review thyroid |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1251866/full |
| work_keys_str_mv | AT stefanopalomba polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT carlacolombo polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT carlacolombo polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT andreabusnelli polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT andreabusnelli polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT donatellacaserta polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT giovannivitale polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature AT giovannivitale polycysticovarysyndromeandthyroiddisorderacomprehensivenarrativereviewoftheliterature |