Thyroid hormones and menstrual cycle function in a longitudinal cohort of premenopausal women

• Type of Material: Article
• Authors: Melanie H. Jacobson, Emory University; Penelope Howards, Emory University; Lyndsey Darrow, Emory University; Juliana W. Meadows, Centers for Disease Control & Prevention; James S. Kesner, Centers for Disease Control & Prevention; Jessica B Spencer, Emory University; Metrecia L. Terrell, Emory University; Michele Marcus, Emory University
• Language: English
• Date: 2018-05-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 John Wiley & Sons Ltd
• Final Published Version (URL): http://dx.doi.org/10.1111/ppe.12462
• Title of Journal or Parent Work: Paediatric and Perinatal Epidemiology
• ISSN: 0269-5022
• Volume: 32
• Issue: 3
• Start Page: 225
• End Page: 234
• Grant/Funding Information: Funding was provided by the National Institute of Environmental Health Sciences; National Institutes of Health (Grants R01ES012014, P30ES019776, R21ES023927, R01ES024790, and R01ES08341); the Environmental Protection Agency (Agreement Number R825300); the Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive, Perinatal, & Pediatric Training Grant (T32HD052460); and the National Institute for Occupational Safety and Health Environmental and Occupational Epidemiology Training Grant (5T03OH008609-10).; This work was additionally supported by the Laney Graduate School and the Livingston Fellowship at Emory University.
• Keywords: DISTURBANCES; euthyroid; Pediatrics; HYPERTHYROIDISM; progesterone; Obstetrics & Gynecology; thyroid hormones; Science & Technology; oestrogen; DISEASE; SMOKING; menstrual cycle function; Life Sciences & Biomedicine; REPRODUCTION; ESTROGEN; OVULATION; DYSFUNCTION; Public, Environmental & Occupational Health; LENGTH; women's health; LUTEINIZING-HORMONE
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health; Health Sciences, Obstetrics and Gynecology

Abstract

Background: Previous studies have reported that hyperthyroid and hypothyroid women experience menstrual irregularities more often compared with euthyroid women, but reasons for this are not well-understood and studies on thyroid hormones among euthyroid women are lacking. In a prospective cohort study of euthyroid women, this study characterised the relationship between thyroid hormone concentrations and prospectively collected menstrual function outcomes. Methods: Between 2004-2014, 86 euthyroid premenopausal women not lactating or taking hormonal medications participated in a study measuring menstrual function. Serum thyroid hormones were measured before the menstrual function study began. Women then collected first morning urine voids and completed daily bleeding diaries every day for three cycles. Urinary oestrogen and progesterone metabolites (estrone 3-glucuronide (E13G) and pregnanediol 3-glucuronide (Pd3G)) and follicle-stimulating hormone were measured and adjusted for creatinine (Cr). Results: Total thyroxine (T4) concentrations were positively associated with Pd3G and E13G. Women with higher (vs lower) T4 had greater luteal phase maximum Pd3G (Pd3G = 11.7 μg/mg Cr for women with high T4 vs Pd3G = 9.5 and 8.1 μg/mg Cr for women with medium and low T4, respectively) and greater follicular phase maximum E13G (E13G = 41.7 ng/mg Cr for women with high T4 vs E13G = 34.3 and 33.7 ng/mg Cr for women with medium and low T4, respectively). Conclusions: Circulating thyroid hormone concentrations were associated with subtle differences in menstrual cycle function outcomes, particularly sex steroid hormone levels in healthy women. Results contribute to the understanding of the relationship between thyroid function and the menstrual cycle, and may have implications for fertility and chronic disease.