AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2642-9756/110
1 Department of Obstetrics and Gynecology, Faculty of Medicine - Zagazig University. Sharkia, Egypt
2 Department of Tropical Medicine, Faculty of Medicine - Zagazig University. Sharkia, Egypt
*Corresponding Author: Ahmed M. Radwan. Department of Obstetrics and Gynecology, Faculty of Medicine - Zagazig University. Sharkia, Egypt.
Citation: Ahmed M. Radwan, Sherweet M. Ahmed. (2022). Thyroid Dysfunction in Postmenopausal Women: Across Section Study, J. Women Health Care and Issues, 5(6) DOI: 10.31579/2642-9756/110
Copyright: © 2022 Ahmed M. Radwan. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 02 August 2022 | Accepted: 19 August 2022 | Published: 05 September 2022
Keywords: thyroid dysfunction; postmenopausal women
This study was conducted on postmenopausal women who went to internal medicine and gynaecological outpatient clinics for various purposes during the period from 1/3/2021 to 1/2/2022. The aim of this work was to study possible relationship between thyroid disorders and menopause. Our study included 80 women who were postmenopausal. Patient with history of thyroid disorders, autoimmune diseases, liver disease, renal disease and patient on amiodarone or other drugs that affect thyroid function were excluded from the study.All cases were subjected to the following: History , examination , Routine investigations and Thyroid gland hormones (TSH, free T3 and free T4) and thyroid autoantibodies (TPO and TG).The result of this study showed that: Among our post-menopausal women there was 17.5% of them had thyroid disorders. The frequency of different thyroid disorders in our post-menopausal women was as follow: 10 women out of 80 (representing 12.5%) were overt hypothyroid, 4 women (5%) had subclinical hypothyroidism and 22 women (27.5%) classified as non-thyroidal illness syndrome. While 44 women (55%) were euthyroid. Thyroid auto antibodies were detected in 15% in cases of the study distributed as follow: 5% were overt hypothyroid, 2.5% had subclinical hypothyroidism and 7.5% were euthyroid women.
Conclusion: Thyroid disorders are common in women in postmenopausal age. Overt hypothyroidism is the most common thyroid disorder in them, followed by subclinical hypothyroidism and thyroid autoantibodies are present in high percentage of women whether they have thyroid disorders or are euthyroid.
There has been expanding enthusiasm for thyroid capacity in the elderly in view of relationship of thyroid status with incapacity, intellectual capacity, risk of cardiovascular sickness, and life span [1]. Thyroid autoimmunity is more regular in females than in males, presumably as a result of the activity of sex hormones, estrogens and androgens on the invulnerable framework [2]. In a group based multicentric investigation of the characteristic history of the menopausal 9.6% predominance of increased TSH outside the euthyroid extent was discovered [3]. It is found that serum TSH increase (mean increment of 0.32mU/L) with no change in free T4 with menopause [4]. A few appearances of menopause are like the signs and side effects associated with thyroid brokenness. Hot flushes, bigotry to warmth, sweating, palpitations, fractiousness, a sleeping disorder, and fast changes in temperament can be followed back to a case of hyperthyroidism, while skin decay, clogging, fragile hair, periorbital edema and expansion of weight are appeared in hypothyroid subjects [5].
Aim of the Study: This study was designed to study possible relationship between thyroid disorders and menopause.
Subjects and Methods : This study was Cross-sectional study conducted at United doctors’ hospital, Jeddah KSA, and included 80 postmenopausal women who went to internal medicine and gynecology outpatient clinic for various purposes during the period from 1/3/2021 to 1/2/2022.
Aim of the work: This study was designed to study possible relationship between thyroid disorders and menopause
Inclusion criteria: Women above fifty years with cessation of menstruation. Post menopause can be defined as stoppage of menstrual flow for a period of 12 months and above 6.
Exclusion criteria:
• Patient with history of thyroid disorders.
• Patient receives drugs affecting thyroid function e.g amiodaron.
• Autoimmune disease.
• Chronic disease (liver disease-renal disease).
All patients will undergo:
Complete History taking, Full examination, routine investigations and
• Thyroid gland hormones (TSH, free T3 and free T4) and thyroid autoantibodies (TPO and TGA)
Table (1): showed the demographic data of our subjects. The mean age of our subjects was 61.6±8.6 years and the mean BMI was 34.6±4 kg/m2. Most of our cases were obese, thyroid disorders in post-menopausal women were 17.5%. The frequency of different thyroid disorders in our post-menopausal women was as follow: 12.5% were overt hypothyroid, 5% were sub clinically hypothyroid and 27.5% classified as nonthyroidal illness syndrome. While 55% were euthyroid. Table (2) showed that prevalence of thyroid auto antibodies among our postmenopausal women were as follow: 5% were overt hypothyroid, 2.5% had subclinical hypothyroidism and 7.5% were euthyroid women. Thyroid auto antibodies were detected in 15%. table (3) showed that 27.5% were hypertensive where mean systolic blood pressure was 162.53±14.1mmHg and mean diastolic blood pressure was 98.33±9.6 mmHg. While the other 72.5% were normotensive where mean systolic blood pressure was 121.47± 12.5mmHg and 76.938.3 mmHg. table (4) showed that 27.5% were diabetic, with mean FBG: 195.36 mg/dl and mean PPBG: 278.21 mg/dl. and the others 72.5% were euglycemic. Table (5) showed that there was negative nonsignificant association between age, T3 (r= -0.14) and TSH (r= -0.1). There was positive non-significant association between age and T4 (r=0.06), TPO (r=0.06) and TG (r=0.01). (P>0.05), There was positive significant association between BMI and TSH (r=0.41) (P =0.01), TPO ab (r=0.34) (P =0.05) and TG ab (r=0.40) (P =0.01). But there was positive nonsignificant association between BMI, T3and T4 (P >0.005). Table (6) showed that 45% of our cases had different types of comorbidity distributed as follow: Hypertension in 8 women (10%), DM in 8 women (10%), both DM & Hypertension in 14 women (17.5%), cancer cervix in only 2 woman (2.5%) and cholecystitis in 4 women (5%). While 55% (44 women out of 80 women) had no associated comorbidity. Table (7) showed association between hypertension, DM and other comorbidities with hypothyroidism. Among different types of comorbidities there was positive significant association between hypertension and hypothyroidism (x2=0.0) (P =0.02), also there was positive significant association between hypothyroidism and DM (x2=8.03) (P =0.004). However, there was positive nonsignificant association between hypothyroidism and other comorbidities (x2=0.63) (P =0.42).
Table 1: Mean age, BMI and Prevalence of thyroid dysfunction of study group
Table 2: Prevalence of thyroid auto antibodies among study group
Table 3: Mean value of Arterial Blood Pressure in study group
Table 4: Mean value of blood glucose in study group.
Table 5: Correlation between age, BMI and thyroid function of study group.
Table 6: Different Comorbidity associated with study group.
Table 7: Association between hypertension, DM and other comorbidities with hypothyroidism in study group.
This study was designed to study possible relationship between thyroid disorders and menopause. Our study revealed that demographic data of our subjects were: the mean age was 61.6±8.6 years and the mean BMI was 34.6±4 kg/m2. Most of our cases were obese. Among our post-menopausal women there was 17.5% of them had thyroid disorders. The frequency of different thyroid disorders in our post-menopausal women was as follow: 10 women out of 80 (representing 12.5%) were overt hypothyroid, 4 women (5%) were sub clinically hypothyroid and 22women (27.5%) classified as non-thyroidal illness syndrome. While 44 women (55%) were euthyroid.
As regard thyroid auto antibodies our study revealed that it was detected in 15% of our cases distributed as follow: 5% were overt hypothyroid, 2.5% had subclinical hypothyroidism and 7.5% were euthyroid women.
In our study we found that TPO ab were present in 10 cases: 2 woman was hypothyroid, another woman had subclinical hypothyroidism and 6 women were euthyroid. While only 2 woman diagnosed as overt hypothyroidism had TG ab. Our study uncovered that unmistakable hypothyroidism spoke to 12.5%.
As respect subclinical hypothyroidism, our study uncovered that it speaks to 5% of our cases; this is in concurrence with Fatourechi et al., 2019 who found that commonness of subclinical hypothyroidism is 3-8%, expanding with age and being more regular in ladies. However different studies uncovered higher rate of subclinical hypothyroidism where Chakera et al., 2012 found that subclinical hypothyroidism reach up to15% to 18% in ladies who are more than 60 years old. [7,8]
Frequencies of unmistakable and subclinical hypothyroidism change among the studies. Such varieties could be connected with a few nearby variables, incorporating contrasts in iodine admission among populaces, contrasts in cut-off qualities utilized for thyrotropin and FT4 levels and systems of test choice among studies.
Our study showed that non-thyroidal ailment disorder spoke to 27.5% of our postmenopausal ladies , in consent to our outcomes, Tognini et al., 2020 found that the commonness of NTIS (particularly low T3 disorder) in hospitalized more seasoned patients, was 31.9% .While in another study, Adler and Wartofsky, 2017 found that the pervasiveness of NTIS is around 11–18% in records of non-chose hospitalized patients and expansions up to 60–70% among patients admitted to serious consideration unts.[9,10] Some of our cases were admitted to intensive care unit while the majority were admitted to surgery and gynecology departments and prepared for surgery, so they were under stress which is an important cause of nonthyroidal illness syndrome. Also, we found that there was mild decrease in free T3.
On studying thyroid autoantibodies, our study revealed that it was present in 15% of our postmenopausal women, and distributed as follow:5% (two out of forty women) were overt hypothyroid, 2.5% (one out of forty women) had subclinical hypothyroidism and 7.5% (three out of forty women) were euthyroid women. Vanderpump, 2015 found that early after death thinks about affirmed histological proof of constant immune system thyroiditis in 27% of grown-up ladies, with an ascent in recurrence more than 50 years. [11]
In our study there was sure thyroid autoantibodies in 13.6% (3 out of 22women) of euthyroid cases, this is in consent to our study, Biondi and Cooper 2018 who found that the reported commonness of distinguishable TGAb and TPOAb levels were 10 and 12% of the solid populace. [12]
The vicinity of hostile to TPO and against Tg antibodies (TgAb) in the blood can be utilized to analyze fundamental autoimmunity without clinical side effects [13].
90% of patients with Hashimoto's illness have hoisted flowing TgAb, the vicinity of high TgAb, alone, is not adequate to make an analysis, as this variation from the norm is likewise found in patients with other immune system issue, for example, rheumatoid joint pain and type I diabetes [14].
On considering relationship in the middle of age and thyroid hormones or thyroid antibodies, it was found that there was negative non-huge relationship in the middle of age and T3 and TSH. In any case, there was certain non-noteworthy relationship in the middle of age and T4 or thyroid antibodies. likewise, Suzuki et al., 2012 found that in females, the free thyroid hormone levels were not changed with maturing but rather, in opposition to our stuy, TSH level expanded in age-subordinate way. Benseñor et al., 2019 found that recurrence of thyroid issue did not change as indicated by age, likewise against thyroperoxidase antibodies were steady and did not change as per age. In spite of our study, information from the National Health and Nutrition Examination Survey (NHANES III) demonstrated a predominance of hostile to thyroperoxidase antibodies that increments with age in both men and ladies [15,16,17].
Mean age of women involved in our study was 61 years, while most of studies which found increase in thyroid hormones and antibodies with age were conducted on elderly women. Our results may be also due to small number of cases in our sample.
On studying BMI, our study revealed that most of our postmenopausal women were obese. There was positive significant association between BMI and TSH, TPO ab and TG ab. In consent to our discoveries, Amrita et al., 2013 concentrated on the relationship between various BMI gatherings and serum TSH and they reported that as the BMI expanded mean estimation of serum TSH additionally expanded. Be that as it may, Svare et al., 2019 found a negative relationship between standard BMI and serum TSH [18,19]
Fat tissue could impact thyroid hormones in different ways. In any case, the effect may be a direct result of a change in deiodinase activity in central and/or periphery tissue, Second, hormone resistance in substantial subjects as an outcome of a T3 receptor reduction has been proposed. Third, a mostly bioinactive TSH protein in heavy subjects has been hypothesized [20].
Our study demonstrated that 27.5% of our cases were diabetic. (table.10). There was sure huge relationship in the middle of hypothyroidism and DM. In consent to our outcome, a study done by Akbar et al., 2016 reported a pervasiveness of thyroid issue in 16% in Saudi T2DM patients [21]
Our study 27.5% were hypertensive, In consent to our outcomes, Grais et al., 2015 found that the mostwidely recognized cardiovascuar indications of hypothyroidism is diastolic hypertension, since hypothyroidism diminishes endothelial-interceded vasorelaxation and vascular consistence and in this way, hoisted diastolic circulatory strain. [22]
In the hypothyroid state, the thickness of α1‑adrenoreceptors is expanded while β‑adrenoreceptors are lessened in vascular beds. Activities of α1‑adrenoreceptors for the most part include smooth muscle cell constriction, bringing about vasoconstriction in the veins, while decreased β-adrenoreceptors can affect low heart yield, renin emission from the kidneys, low lipolysis and anabolism in skeletal muscle. [23].
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
