Thyroid status in patients with endometrial pathology

The aim of this study was to investigate the functional status of the thyroid gland in women with endometrial hyperplastic processes, in light of the increasing interest in the role of thyroid dysfunction in the aetiopathogenesis of proliferative changes in the uterine mucosa. The study included 30 women of late reproductive and perimenopausal age (14-50 years), diagnosed with various forms of endometrial hyperplastic pathology, based at the Zaporizhzhia Medical Academy of Postgraduate Education, Ministry of Health of Ukraine. The methodology involved clinical and laboratory assessment of patients, including pelvic ultrasound, histological examination of the endometrium, and evaluation of thyroid-stimulating hormone, free thyroxine and triiodothyronine levels, along with antibodies to thyroid peroxidase. The main findings demonstrated that women with endometrial hyperplasia frequently exhibited concomitant thyroid dysfunction, including subclinical or overt hypothyroidism. An elevated thyroid-stimulating hormone level (3.8 ± 1.2 mIU/L) was observed in patients with endometrial hyperplasia compared to the control group, alongside increased concentrations of thyroid peroxidase antibodies, indicating an autoimmune origin of the dysfunction. Analysis revealed a correlation between the severity of thyroid dysfunction and the morphological variant of hyperplastic endometrial changes: clinically significant thyroid dysfunction was more prevalent in women with atypical hyperplasia. These findings support the rationale for routine thyroid function screening in women with endometrial hyperplasia, to detect latent thyroid pathology, which may serve as both a background and a triggering factor in the development of proliferative endometrial disorders. Thus, the study underscores the importance of an integrated approach to the diagnosis and management of endometrial hyperplastic processes, considering the status of the thyroid gland and the endocrine system more broadly