June 12, 2020

Hypothyroidism and Atypical Uterine Bleeding

Imagine your house is on fire and the fire alarm goes off. Your natural response is calling 911 and putting the fire out! Not to shut off the fire alarm and pretend everything is well. However, THAT is exactly what the pill does in the case of atypical uterine bleeding (or any other issue you could possibly think of).

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Atypical uterine bleeding refers to bleeding that is not associated with a normal menstrual period or after giving birth. So spotting at various times throughout the menstrual cycle, spotting after intercourse, heavy menstrual bleeding, or cycles that are shorter than 24 days or longer than days [1] 

We know that the thyroid regulates both a person’s metabolism as well as hormonal activities. A woman’s menstrual cycle is governed by the intricate interplay between hormones and is thus influenced by the thyroid. That means, if there is an issue with a woman’s thyroid, she might also experience menstrual cycle irregularities! [2]

One study found a significant correlation between hypothyroidism (presenting as either high TSH or low T4) and abnormal uterine bleeding [3]. Another study lists the connection between thyroid disease as well as the use of SSRIs and abnormal uterine bleeding [4].

These researchers write that “Hypothyroidism is closely related to infertility. Hypothyroidism can cause changes in the levels of sex hormones and is involved in many reproductive diseases, including abnormal sex gland development, menstrual problems (mainly oligo- or amenorrhea), breakthrough bleeding, anovulation, and infertility” [5]

All of these researchers agree that thyroid dysfunction has an impact on a woman’s menstrual cycle and her fertility. And many of them advocate for evaluating a woman’s thyroid as one of the first steps when addressing menstrual irregularities as well as promoting treatment for this underlying condition. Evidence suggests that regulating the thyroid with medication reduced women’s chances of abnormal bleeding [3, 6]. 

Suffice it to say that there is a plethora of evidence to suggest THAT there is a correlation between a dysfunctional thyroid and abnormal uterine bleeding. However the only two treatment options presented are synthetic T4 medication as well as birth control pills.

I do agree that we need to treat the underlying issue of the thyroid, but not necessarily just by blindly adding T4 to the person’s medicine shelf. 

A rather infuriating recurrence in the scientific literature was that of administering birth control pills [4]. I agree that the thyroid medication might be necessary, but shutting a woman’s whole reproductive system down will in no way address the underlying issue. The fake hormones of the birth control pill will simply mask the issue and force a “regular” withdrawal bleed to mimic a normal cycle when, in fact, the body is out of balance and is screaming for support. 

Imagine your house is on fire and the fire alarm goes off. Your natural response is calling 911 and putting the fire out! Not to shut off the fire alarm and pretend everything is well. However, THAT is exactly what the pill does in the case of atypical uterine bleeding (or any other issue you could possibly think of).

In her book The Fifth Vital Sign Lisa Hendrickson-Jack outlines an entire chapter to “restoring normal cycles with a thyroid disorder”. She presents several nutrients that are involved in normal thyroid function, such as iodine, selenium, zinc, iron, magnesium, and vitamin A [7].

I will be writing a part 2 to this blog focusing exactly on that: how to support thyroid function naturally to heal and optimize the menstrual cycle. (Psst, my email list will be the first to be notified, so make sure you’re signed up!)

Now I want to hear from you: have you experienced atypical uterine bleeding? What does that look like for you? What did your doctor do to help you?

References:

[1] Abnormal Uterine Bleeding, American College of Obstetricians and Gynocologists

[2] Role of Thyroid Dysfunction in Patients with Menstrual Disorders in Tertiary Care Center of Walled City of Delhi, Ajmani, 2015

[3] Thyroid Dysfunction and Abnormal Uterine Bleeding, Taba et. al. 2019

[4] Abnormal Uterine Bleeding, Albers, 2004

[5] Relationship between Hypothyroidism and Endometrial Cancer, Wang, 2019

[6] Severe Hypothyroidism Leading to Life Threatening Menorrhagia, Mathieu, 2017

[7] The Fifth Vital Sign, Lisa Hendrickson-Jack, 2019

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Hi, I'm Amy! I’m a bilingual English/German mama to two little girls, wife, Holistic Reproductive Health Practitioner, certified Fertility Awareness Educator, and dark chocolate lover.