ASSOCIATION BETWEEN THYROID DYSFUNCTION AND OVARIAN MORPHOLOGY IN WOMEN WITH MENSTRUAL DISORDERS

Abstract

Background: Thyroid hormones are significant hormones in female reproductive physiology affecting menstrual cyclicity, ovarian steroidogenesis, follicular development and ovulation. Thyroid dysfunction can be associated with irregular menstrual periods and can cause changes in the morphology of the ovary in ultrasound examination.

Objective: To determine the association between thyroid dysfunction and ovarian morphology among women presenting with menstrual disorders.

Methods: This descriptive cross sectional study was conducted during the period from January 2025 to June 2025 in the Muhammad College of Medicine, Peshawar. It was the non-probability consecutive sampling, which resulted in inclusion of 88 women suffering from menstrual disorders. The data collected were demographic and clinical which were entered onto a structured proforma. The thyroid function was determined by assessing the level of serum TSH, free T3 and free T4. The subjects were divided into two groups: euthyroid and thyroid dysfunction. Pelvic ultrasonography was done to evaluate the morphological characteristics of the ovary, such as ovarian volume, number of follicles, stromal echogenicity, polycystic ovarian morphology and simple ovarian cysts. Data was analysed using SPSS version 26. P value < 0.05 was taken as statistically significant.

Results: The mean age of participants was 28.7 ± 6.1 years, while the mean BMI was 25.9 ± 4.3 kg/m². Oligomenorrhea was the most common menstrual disorder, observed in 31 (35.2%) women. Thyroid dysfunction was present in 37 (42.0%) participants, with subclinical hypothyroidism being the most frequent abnormality. Normal ovarian morphology was observed in 44 (50.0%) women, polycystic ovarian morphology in 28 (31.8%), and simple ovarian cysts in 16 (18.2%). Polycystic ovarian morphology was significantly more frequent among women with thyroid dysfunction compared with euthyroid women (45.9% vs 21.6%, p=0.041). Women with thyroid dysfunction also had significantly higher mean ovarian volume, follicle count, and stromal echogenicity. TSH level showed a positive correlation with ovarian volume and follicle count.

Conclusion: Thyroid dysfunction was significantly associated with altered ovarian morphology among women with menstrual disorders. Subclinical hypothyroidism was the most common thyroid abnormality, and women with thyroid dysfunction showed a higher frequency of polycystic ovarian morphology, increased ovarian volume, and higher follicle count. Thyroid function testing should be considered as part of routine evaluation in women presenting with menstrual irregularities.