Thyroid function in women with polycystic ovary syndrome

Bharti Patidar, Rekha Sapkal


Background: This study aimed to assess the serum thyroid stimulating hormone (TSH) levels in women with polycystic ovary syndrome (PCOS), and its variation with obesity, insulin resistance and LH:FSH ratio.

Methods: This was a facility based cross sectional study conducted for a period of 18 months on a total of 165 females with PCOS diagnosed based on Rotterdam 2003 criteria. A thorough history and clinical and anthropometric examination was conducted for all females. USG abdomen and serum TSH levels and fT4 were also done and the findings were recorded on questionnaire.

Results: Subclinical hypothyroidism was documented in 17% females with PCOS. No statistically significant difference in mean values of LH:FSH ratio, insulin resistance, and obesity parameters were noted among euthyroid and subclinical hypothyroid females with PCOS (p>0.05). TSH levels in present study showed a statsitcally significant positive correlation with BMI.

Conclusions: The proportions of thyroid disorders are higher in females with PCOS and they both may present with various similar clinical features. BMI in females with PCOS has significant positive correlation with TSH levels. However, it is not clear whether thyroid dysfunction has significant effect on insulin resistance.


Thyroid dysfunction, PCOS, Insulin resistance, Obesity, LH:FSH ratio

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Rotterdam ESHRE/ASRM‐Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long‐term health risks related to polycystic ovary syndrome (PCOS). Human reproduction. 2004;19(1):41-7.

Kowalczyk K, Franik G, Kowalczyk D, Pluta D, Blukacz Ł, Madej P. Thyroid disorders in polycystic ovary syndrome. Euro Review Med Pharmacol Sc. 2017;21:346-60.

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine reviews. 2012;33(6):981-1030.

Devru N, Dharmshaktu P, Kumar G, Dutta D, Kulshreshtha B. Phenotypic presentation of adolescents with overt primary hypothyroidism. J Pediatr Endocrinol Metab. 2018;31(4):415-20.

Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab 2013;17:647-52.

Marwaha RK, Tandon N, Ganie MA, Kanwar R, Sastry A, Garg MK et al. Status of thyroid function in Indian adults: Two decades after universal salt iodization. J Assoc Physicians India. 2012;60:32-6.

Sinha U, Sinharay K, Saha S, Longkumer TA, Baul SN, Pal SK. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India. Indian J Endocrinol Metab. 2013;17:304-9.

Benetti-Pinto CL, Berini Piccolo VR, Garmes HM, TeatinJuliato CR. Subclinical hypothyroidism in young women with polycystic ovary syndrome: An analysis of clinical, hormonal, and metabolic parameters. Fertil Steril. 2013;99:588-92.

Ramanand SJ, Ghongane BB, Ramanand JB, Patwardhan MH, Ghanghas RR, Jain SS. Clinical characteristics of polycystic ovary syndrome in Indian women. Indian J Endocrinol Metab. 2013;17:138-45.

Janssen OE, Mehlmauer N, Hahn S, Offner AH, Gärtner R. High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur J Endocrinol. 2004;150:363-9.

Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology. 2018;14(5):270.

Goyal D, Relia P, Sehra A, Khandelwal D, Dutta D, Jain D, Kalra S. Prevalence of hypothyroidism and thyroid autoimmunity in polycystic ovarian syndrome patients: A North Indian study. Thyroid Res Pract 2019;16:55-9

Lamberg BA: Glucose metabolism in thyroid disease. Acta Med Scand. 1965;178(3):351-62.

AbuFaza M, Abdelazim I, Purohit P, Shikanova S, Zhurabekova G, Karimova B et al. The diagnosis and the reproductive and metabolic consequences of polycystic ovary syndrome. J Obstet Gynecol Investig. 2018;1:67-73.

Vignesh JP, Mohan V. Polycystic ovary syndrome: A component of metabolic syndrome? J Postgrad Med. 2007;53:128-34

Benetti-Pinto CL, Berini Piccolo VR, Garmes HM, TeatinJuliato CR. Subclinical hypothyroidism in young women with polycystic ovary syndrome: An analysis of clinical, hormonal, and metabolic parameters. Fertil Steril. 2013;99:588-92.

Enzevaei A, Salehpour S, Tohidi M, Saharkhiz N. Subclinical hypothyroidism and insulin resistance in polycystic ovary syndrome: is there a relationship? Ira J Reprod Med. 2014;12(7):481.

Singla R, Gupta Y, Khemani M, Aggarwal S. Thyroid disorders and polycystic ovary syndrome: An emerging relationship. Indian J endocrinol metab. 2015;19(1):25.

Muscogiuri G, Sorice GP, Mezza T, Prioletta A, Lassandro AP, Pirronti T et al. High-normal TSH values in obesity: Is it insulin resistance or adipose tissue's guilt? Obesity (Silver Spring). 2013;21:101-6.

Duntas LH, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: The multifold role of leptin. Thyroid. 2013;23:646-53.