Possible association between subclinical hypothyroidism and age at menopause in Colombian women

Abstract

Objective

To evaluate the association between subclinical hypothyroidism with early menopause, premature menopause, and last menstrual bleeding before the natural age of menopause.

Methods

This was a cross-sectional study conducted in 643 postmenopausal women aged 40–69 years. Groups were formed according to last menstrual episode: ≥45 [Natural age at menopause], 40–44 and [Early menopause], <40 [Premature menopause], and <45 [last menstrual episode before the natural age of menopause]. The Zulewski scale was applied to identify manifestations related to hypothyroidism and subclinical hypothyroidism, diagnosed with a serum TSH > 4.5 µIU/mL plus T4-free between 0.7 and 1.9 ng/dL.

Results

It was found that 24.4% had the last menstrual episode before the natural age of menopause, 18.6% had early menopause, and 5.7% had premature menopause. Subclinical hypothyroidism was diagnosed in 4.5% of patients. Among women with subclinical hypothyroidism, there was a higher frequency of early menopause, premature menopause, and last menstrual episode before the natural age of menopause, than in women without subclinical hypothyroidism (p < 0.05). Paresthesia (50%) and dry skin (40.7%) were the most reported hypothyroidism-related manifestations. Early menopause, premature menopause, and last menstrual episode before the natural age of menopause were associated with subclinical hypothyroidism, OR: 3.37 [95% CI: 1.40–8.10], OR: 4.31 [95% CI: 1.24–14.97], and OR: 3.57 [95% CI: 1.57–8.10], respectively.

Conclusions

The last menstrual episode before the natural age of menopause, early menopause, and premature menopause were significantly associated with a higher chance of subclinical hypothyroidism

Keywords:

• Age at menopause
• early menopause
• menopause
• premature menopause
• climacteric
• hypothyroidism
• thyroid-stimulating hormone

Acknowledgments

The authors would like to thank the women who accepted and participated in the study, Dr. Jorge Contreras Saldarriaga who was active during the fieldwork phase, Ms. Mabel Vergara Borja, and Ms. Ana Isabel Castro Lagares for their devoted coordination and logistical planning, custody of physical and digital elements and to Ms. Judith Ramos Vásquez for helping in venous blood collection, sample preparation and transfer to the laboratory. In addition, we thank the community associations, senior citizen’s center and life center of the city of Cartagena, Colombia, and the management and scientific staff of Laboratorio Clínico Santa Lucía, Cartagena, Colombia.

Disclosure statement

The author(s) declare having no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Author contributions

AM-C (conceptualization of the ‘Thyroid and Menopause’ project, definition of its products, data curation, methodology, and statistical analysis, writing and structuring of the initial draft, argument review, and editing of this article). AM-B (conceptualization of the research line of the project, methodology, and statistical analysis, writing, numerical revision of references, and grammatical adjustment, general revision, and editing). S S-Z (data review, writing, English grammar adjustment, networking activities, and international networking). All authors contributed conceptually and approved the final manuscript.

Data availability statement

All required information regarding the protocol of the study and collected data will be made available upon a reasonable request to the researchers who provide a methodologically sound proposal. Only the analysis required to achieve the aims in the approved proposal will be permitted. Proposals should be directed to [email protected]

Additional information

Funding

The research project ‘Menopause and Thyroid’ was the winner in the Eleventh Call of the University of Cartagena. Colombia for the financing of research projects and was approved by Resolution 01385-2021 of the university. Subsequently, the Women’s Health Research Group and the Vice-Rectory for Research of the University of Cartagena signed the Commitment Act 092-2021 for the realization of the project. The directors of the University of Cartagena, Colombia, did not participate in the design of the study, organization of the fieldwork, conservation, or analysis of the data, or in the writing of the final documents intended for scientific or general publication.