Schilddrüse und Polyzystisches Ovarsyndrom

Zusammenfassung

Das polyzystische Ovarsyndrom (PCOS) ist durch Hyperandrogenämie/Hyperandrogenismus, Zyklusstörung und polyzystische Ovarien charakterisiert. Mit einer Prävalenz von 5–8% ist es die wichtigste Ursache für einen unerfüllten Kinderwunsch. Darüber hinaus verursacht es erhebliche kosmetische Probleme (Hirsutismus, Akne, Alopezie). Durch seine Assoziation mit dem metabolischen Syndrom (MBS) stellt es ein ernstzunehmendes kardiovaskuläres Risiko dar. Außerdem ist das PCOS mit einer erhöhten Prävalenz der Hashimoto-Thyreoiditis assoziiert. PCOS und die mit einer Hashimoto-Thyreoiditis assoziierte Hypothyreose stellen unabhängig voneinander ein metabolisches, kardiovaskuläres und gynäkologisches Risiko dar, sodass bei PCOS-Patientinnen ein Schilddrüsenscreening (Schilddrüsensonografie, TSH- und TPO-Antikörper-Bestimmung) empfohlen wird. Höhere TSH-Werte bei Frauen mit PCOS und Hashimoto-Thyreoiditis sind mit einem erhöhten Körpergewicht und BMI assoziiert – möglicherweise kann hier eine Schilddrüsenhormonsubstitution zur Gewichtsabnahme beitragen.

Abstract

The polycystic ovary syndrome (PCOS) is characterized by hyperandrogenemia/hyperandrogenism, irregular menses and polycystic ovaries. With a prevalence of 5–8% it is the main cause of infertility. It also causes profound cosmetic problems (hirsutism, acne, alopecia). Through its association with the metabolic syndrome (MBS) it also represents a significant cardiovascular risk. Furthermore, PCOS is associated with an increased prevalence of autoimmune thyroiditis (AIT). PCOS and the hypothyroidism associated with AIT both pose a metabolic, cardiovascular and gynecological risk. Thus, PCOS patients should be screened for thyroid disorders by thyroid ultrasound and determination of TSH and TPO-antibody levels. Elevated TSH-values in PCOS patients with AIT correlate with an increased body weight and BMI – thyroid hormone replacement may thus be an option for weight reduction in these patients.

Schlüsselwörter

polyzystisches Ovarsyndrom - PCOS - Hashimoto-Thyreoiditis - Autoimmunthyreoiditis - metabolisches Syndrom

Key words

polycystic ovary syndrome - PCOS - autoimmune thyroiditis - AIT - metabolic syndrome

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