Ovarian ultrasound and ovarian and adrenal hormones before and after treatment for hyperthyroidism.
OBJECTIVE
To relate thyroid, steroid and pituitary hormones to ovarian ultrasonographic findings in hyperthyroid patients before and during treatment.


METHODS
Ultrasonography of the ovaries and serum hormone determination by immunoassay were performed before and during thiamazole therapy in 18 women of fertile age treated for hyperthyroidism at the Danderyd Hospital from 1996 to 1998.


RESULTS
When hyperthyreotic, the patients had elevated serum levels of sex hormone-binding globulin (SHBG) and subnormal values of cortisol, free testosterone (fT) and dehydroepiandrosterone (DHEA). In the euthyreotic state following treatment, endocrine variables were normalized. Patients with a short duration of the disease had higher pretreatment levels of free thyroxine (fT4), SHBG and testosterone and lower corticosteroid binding globulin (CBG) and cortisol levels compared to patients with a long duration of the disease. The pretreatment ultrasonographic picture was abnormal in 16 of 18 patients. Of the 8 patients who were examined by ultrasonography after 3 months of treatment, all but 1 showed a normal picture. Samples from patients showing an abnormal ultrasonographic picture had significantly higher fT4 and lower free testosterone (fT) values than samples from patients with a normal ultrasonographic picture.


CONCLUSIONS
Ultrasonographic findings showing a multicystic/multifollicular picture, resembling polycystic ovaries (PCO), in hyperthyroidism may be related to direct effects of thyroid hormones on the ovaries and/or altered intraovarian androgen environment due to elevated SHBG levels. It is highly recommended to assess the thyroid status in patients with multicystic/multifollicular ovaries/PCO.
Skjöldebrand Sparre
L
L
Division of Obstetrics and Gynecology, Karolinska Insititutet, Danderyd Hospital, Stockholm, Sweden. lottie.skjoldebrand@kvk.ds.sll,edu
Kollind
M
M
Carlström
K
K
D000305:Adrenal Cortex Hormones / Q000097:blood*; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use*; D003687:Dehydroepiandrosterone / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006980:Hyperthyroidism / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008713:Methimazole / Q000627:therapeutic use*; D008875:Middle Aged; D010053:Ovary / Q000000981:diagnostic imaging*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014156:Transcortin / Q000032:analysis; D014463:Ultrasonography
D000305:Adrenal Cortex Hormones; D013956:Antithyroid Agents; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D003687:Dehydroepiandrosterone; D008713:Methimazole; D019314:Dehydroepiandrosterone Sulfate; D014156:Transcortin; D013974:Thyroxine; D006854:Hydrocortisone