Unlocking the Link Between PCOS and Hypothyroidism

Understanding PCOS and Hypothyroidism: A Detailed Overview

When discussing how PCOS and hypothyroidism intertwine, it’s crucial to recognize their overlapping impacts on fertility. PCOS, or Polycystic Ovary Syndrome, affects about 10% of women of childbearing age and stands as a leading cause of ovulatory infertility. It disrupts ovarian function, leading to irregular menstrual cycles and often difficulties with conception. 

Similarly, hypothyroidism—a condition where the thyroid gland underperforms and produces insufficient thyroid hormones—poses significant reproductive challenges. Hypothyroidism in women is notorious for causing menstrual cycle abnormalities, disrupted ovarian function, shortened luteal phase, and various hormone imbalances. These disruptions can make it harder to predict ovulation, leading to challenges in achieving pregnancy. 

The coexistence of PCOS and hypothyroidism in women is not uncommon, though the underlying reasons remain elusive. Some studies suggest that women with PCOS have a higher prevalence of hypothyroidism compared to those without PCOS. This dual burden further complicates fertility issues, often requiring a multi-faceted treatment approach. 

It’s also important to note that pregnancy itself increases the risk of thyroid disorders by six-fold. Ensuring thyroid health before and during pregnancy is paramount to avoid complications such as premature delivery and fetal deaths. Therefore, managing both PCOS and hypothyroidism effectively is vital for improving reproductive outcomes and ensuring healthier pregnancies. 

The Surprising Connection between PCOS & Hypothyroidism

A recent systematic review found a clear relationship between PCOS & subclinical hypothyroidism with women with PCOS more likely to be diagnosed with sub-clinical hypothyroidism. Sub clinical hypothyroidism occurs when Thyroid Stimulating Hormone (TSH) is elevated & thyroid hormones are normal. The exact reasons behind this connection are still being studied, but it is believed to be related to hormonal imbalances within the body.

Women diagnosed with both PCOS and subclinical hypothyroidism often experience a compounded set of symptoms, which can significantly impact their overall health and fertility. It’s essential to understand that while subclinical hypothyroidism might not exhibit the overt symptoms of full-blown hypothyroidism, the elevated TSH levels can still lead to various reproductive challenges. 

Subclinical hypothyroidism can disrupt the menstrual cycle, leading to irregular periods or anovulatory cycles, where ovulation doesn’t occur. This disruption can make it difficult for women to conceive, as regular ovulation is critical for fertility. Moreover, studies have shown that infertile women with hypothyroidism often have higher prolactin levels compared to those without thyroid issues. Elevated prolactin can further inhibit ovulation and disrupt the balance of reproductive hormones. 

The emotional and psychological impact of managing both PCOS and thyroid conditions cannot be understated. Many women report feelings of frustration and emotional distress when dealing with infertility related to these conditions. Addressing thyroid health, therefore, is not just about physical well-being, but it also plays a crucial role in emotional health and overall quality of life. 

Recent research suggests that treating hypothyroidism might improve fertility outcomes in women with PCOS. By bringing TSH levels within the normal range, it’s possible to restore more. 

The overlapping symptoms of PCOS & Hypothyroidism

Both PCOS and Hypothyroidism share some overlapping symptoms, which can make diagnosis and management  challenging. Here are some common symptoms to look out for:

1. Irregular Menstrual Cycles: Women with PCOS often experience irregular periods, while Hypothyroidism can also cause menstrual irregularities.

2. Weight Gain: PCOS weight gain is a well-known concern, and Hypothyroidism can contribute to it as well.

3. Fatigue: Feeling excessively tired is a symptom of both conditions.

4. Hormone Imbalance: Both PCOS and Hypothyroidism disrupt hormonal balance, leading to various symptoms.

5. Hair Issues: Thinning hair or hair loss can be seen in both conditions.

6. High cholesterol: PCOS can cause high cholesterol to the metabolic impact the condition can have. High cholesterol is also common in those suffering with hypothyroidism

7. Constipation: Constipation & bloating are more common if you have been diagnosed with PCOS and hypothyroidism can also cause constipation.

Hormone Balance: The Key to Management

Managing PCOS and Hypothyroidism often revolves around restoring hormonal balance. Here are some strategies to consider:

1. Nutrition & Lifestyle Changes: Adopting a healthy lifestyle can significantly impact both conditions. International PCOS treatment guidelines recommend that lifestyle changes should be the first line of treatment for all women diagnosed with PCOS.  There is also research to support that exercise can help improve PCOS as well as improve quality of life for those diagnosed with sub-clinical hypothyroidism.
Check out my previous blog posts on nutrition for thyroid health & PCOS.

2. Medication: Hormone replacement therapy is commonly prescribed for Hypothyroidism. In the case of PCOS, oral contraceptives can lower androgens and medications such as metformin can regulate insulin levels. Medication should always be prescribed by a Medical Professional.

3. Supplements. Emerging research shows that supplements such as inositol & selenium for people with subclinical hypo-thyroidism may help to optimise TSH levels & improve symptoms associated with these conditions. It appears that the bodies demands for myo-inositol are high in those who have subclinical hypothyroidism Research is very limited and selenium can be toxic at high doses therefore always speak with a medical professional before commencing any supplementation.

4. Weight Management: PCOS weight loss can be challenging, however maintaining a healthy weight is an important part of managing both conditions.  Consult with a healthcare professional for personalized advice.

5. Monitoring: Regular check-ups and blood tests with you medical doctor & health care team are vital to track hormone levels and ensure that treatment is effective.

Further research is needed to fully understand the link between PCOS & hypothyroidism and to determine if this PCOS directly causes thyroid dysfunction. Based on the current information available, it appears that if you have both conditions, optimising one condition may help the other condition too.

Effective Treatments for PCOS and Hypothyroidism

When it comes to treating both PCOS and hypothyroidism, a tailored and multifaceted approach is often the most effective. Since both conditions can significantly affect your fertility, receiving the right treatment can make a substantial difference. 

For hypothyroidism, the cornerstone of treatment is typically Synthroid (levothyroxine). This synthetic hormone helps normalize your thyroid levels, which in turn can improve menstrual regularity and boost fertility. Many women with hypothyroidism and PCOS find this treatment beneficial, although it’s crucial to work closely with your healthcare provider to monitor and adjust dosages. 

Beyond medication, lifestyle changes are equally important. Maintaining a balanced diet rich in whole foods, coupled with regular exercise, can alleviate some of the symptoms associated with PCOS and hypothyroidism. This holistic approach not only improves your overall well-being but also enhances your chances of conceiving. 

An often-overlooked but essential aspect is stress management. Both PCOS and hypothyroidism can be exacerbated by high stress levels. Incorporating stress-relief techniques like yoga, meditation, or even simple breathing exercises can create a positive impact on your hormonal balance. 

Consulting with a fertility specialist or endocrinologist can offer you a comprehensive treatment plan tailored to your unique needs. Individualized treatments may include hormonal therapies, fertility medications, or assisted reproductive technologies such as In Vitro Fertilization (IVF), especially if conventional treatments do not yield results. 

Remember, with the right treatment and support, managing PCOS and hypothyroidism effectively is entirely possible, paving the way towards improved fertility and overall health.