What It Is
An autoimmune disorder in which the body produces antibodies that attack cells in the thyroid and slow down production of thyroid hormone, resulting in hypothyroidism. It is the most common thyroid disorder in the United States.
Who Gets It
Hashimoto’s disease is an inherited disorder that affects approximately 14 million Americans, according to the American Association of Clinical Endocrinologists. It is seven times more common in women than in men.
An underactive thyroid can cause constipation, heavier periods, weight gain, decrease in appetite, lethargy, depression, cognitive problems, fatigue, dry skin, intolerance to cold, and muscle aches. In many people, the first sign is an enlarged thyroid gland in the neck.
How It's Diagnosed/Detected
Hashimoto’s disease is diagnosed by blood tests that measure levels of the thyroid hormones or antithyroid antibodies. The doctor also may detect an enlarged thyroid during a physical examination.
How It Affects Fertility (And Pregnancy)
An underactive thyroid can cause infertility by preventing ovulation, even when a woman has regular periods. Women with undiagnosed hypothyroidism who do conceive have an increased risk of miscarriage.
Some women with underactive thyroid have elevated levels of prolactin, the hormone that induces production of breast milk after delivery. Excess prolactin can prevent ovulation. Hypothyroidism also can shorten the luteal phase of the monthly cycle, which normally lasts about 12 to 16 days. If the luteal phase is shorter than 10 days, the uterine lining cannot build up sufficiently for an embryo to implant.
Hypothyroidism is treated with a synthetic version of the hormone thyroxine. The body responds as it would to the real thing. Treatment usually prevents further thyroid enlargement and may shrink an enlarged gland.
Of the various threats to fertility, thyroid disorders are among the easiest to identify and treat. If you have symptoms that you think might be cause by Hashimoto’s disease, insist on testing, even if doctors have dismissed your complaints. If you already are being treated for hypothyroidism, you can still conceive and have a healthy pregnancy with a little extra planning and vigilance. Your doctor should monitor blood levels closely to ensure that thyroid hormone levels are in the normal range.
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