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Can elevated thyroid-stimulating hormone levels cause menstrual irregularities?

Aug 02, 2025 Source: Cainiu Health
Dr. Zhang Lu
Introduction
In general, elevated thyroid-stimulating hormone (TSH) levels may lead to menstrual irregularities, a connection primarily associated with hypothyroidism or subclinical hypothyroidism. There is a clear association between elevated TSH and menstrual disorders. Early identification and correction of thyroid dysfunction are key to improving menstrual regularity. It is recommended to combine thyroid function testing with gynecological evaluation.

Generally, elevated thyroid-stimulating hormone (TSH) levels may lead to menstrual irregularities. This association primarily relates to hypothyroidism or subclinical hypothyroidism. A detailed explanation is as follows:

Elevated TSH indicates insufficient secretion of thyroid hormones. Thyroid hormones participate in regulating the female reproductive endocrine axis, and their abnormal levels can affect the synthesis and metabolism of estrogen and progesterone, leading to menstrual disorders. Common manifestations include increased menstrual flow, prolonged menstruation, and irregular cycles; severe cases may result in amenorrhea. Mechanistically, insufficient thyroid hormone weakens the liver's metabolic clearance of estrogen, causing relative accumulation of estrogen in the body. It also affects the pituitary gland's regulation of gonadotropins, interfering with follicular development and ovulation, thereby causing menstrual abnormalities.

If elevated TSH accompanied by menstrual irregularities occurs, timely thyroid function tests are necessary. Once hypothyroidism or subclinical hypothyroidism is confirmed, thyroid function can be corrected by supplementing with levothyroxine sodium tablets. In most cases, menstrual cycles gradually return to normal after TSH levels normalize.

There is a clear association between elevated TSH and menstrual irregularities. Early identification and correction of thyroid dysfunction are key to improving menstrual health. It is recommended to combine thyroid function testing with gynecological evaluation and follow standardized treatment under a physician's guidance to avoid impairing reproductive health due to neglected thyroid issues.

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