폐경 증상을 호소하는 폐경 이행기 여성에서 갑상선 감별 진단의 필요성
The Necessity of Thyroid Function Test of Perimenopausal Women with Menopausal Symptoms
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연구목적: 최근 폐경 증상을 호소하는 여성들에게 호르몬 요법이 일반화 되어가고 있다. 폐경 증상과 갑상선 질환의 증상 사이의 유사성으로 인해 이 두 질환의 감별진단의 중요성이 증가되고 있다. 본 연구에서는 폐경 증상을 호소하는 여성 중 호르몬 치료를 원하는 환자들의 갑상선 질환 감별 진단의 중요성에 대해 초점을 두고 연구를 시행하였다. 연구재료 및 방법: 2007년 1월부터 2011년 3월까지 1년 내에 시작된 폐경 증상을 주 증상으로 경희대학교 병원 산부인과를 찾은 139명의 환자를 대상으로 하였다. 이 중 비전형적인 증상을 호소한 환자 43명을 대상으로 갑상선 질환 감별 검사를 시행하였다. 결과: 갑상선 질환 감별 검사를 시행한 43명 중, 검사 수치상 이상이 있는 환자는 10명이었다. 후향적 조사 중 갑상선 기능 검사를 시행하지 않은 96명의 환자 중 3 명의 환자는 이후 갑상선 기능 검사의 이상이 발견되었다. 결론: 폐경 증상을 호소하는 여성에서 호르몬 치료 전에 갑상선 기능 검사를 시행하는 진료 방침이 설정되어야 할 것이다.
Abstract
Objectives: Hormone therapy is generally chosen to treat women who are experiencing menopausal symptoms. Knowing the overlapping symptoms between menopause and thyroid diseases as well as their increasing trend, it is crucial to differentially diagnose among the two types of diseases. The study is focused on the thyroid function test (TFT) and its significance. It also reflects those who are in the menopausal transition state, suffering from premenopausal symptoms, and therefore, want to be treated with hormone therapy. Methods: Endocrinologic diagnosis for menopause was performed in 139 patients who complained of menopausal symptoms and irregular menstruation within the past year and hence, visited the Department of Obstetrics and Gynecology, Kyung Hee University Hospital in order to obtain consultation from January 2007 to March 2011. We made observations using the retrograde method. Among these women, 43 patients tested for TFT for their atypical menopausal symptoms. Results: Among the 43 patients who tested for TFT, 10 patients showed abnormal TFT and 3 patients who did not take TFT at our department were found to have the thyroid disease later by other clinics. Conclusion: In order to differentiate thyroid disease, practical guidelines should be prepared for the management of women with menopausal transition.
참고문헌 (17)
- World Health Organization, "Research on the menopause in the 1990s. Report of a WHO Scientific Group", World Health Organ Tech Rep Ser, 866, pp.1~107 (1996)
- Bruce D, "Symptoms of the menopause", Best Pract Res Clin Obstet Gynaecol, 23, pp.25~32 (2009)
- Birkhauser MH, "Updated practical recommendations for hormone replacement therapy in the peri- and postmenopause", Climacteric, 11, pp.108~123 (2008)
- Badawy A, "Can thyroid dysfunction explicate severe menopausal symptoms?", J Obstet Gynaecol, 27, pp.503~505 (2007)
- Shifren JL, "Menopause, In Berek & Novak’s gynecology. 14th ed", pp.1323~1340 (2007), Lippincott Williams & Wilkins
- Speroff L, "Clinical gynecologic endocrinology and infertility. 7th ed" (2005), Lippincott Williams & Wilkins
- Soules MR, "Executive summary: Stages of Reproductive Aging Workshop (STRAW)", Fertil Steril, 76, pp.874~878 (2001)
- Rymer J, "Extracts from “Clinical evidence”: menopausal symptoms", BMJ, 321, pp.1516~1519 (2000)
- Practice Committee of American Society for Reproductive Medicine., "The menopausal transition", Fertil Steril, 90, pp.S61~S65 (2008)
- McKinlay SM, "The normal menopause transition", Maturitas, 61, pp.4~16 (2008)
- Faddy MJ, "Accelerated disappearance of ovarian follicles in midlife : implications for forecasting menopause", Hum Reprod, 7, pp.1342~1346 (1992)
- Klein NA, "Decreased inhibin B secretion is associated with the monotropic FSH rise in older, ovulatory women: a study of serum and follicular fluid levels of dimeric inhibin A and B in spontaneous menstrual cycles", J Clin Endocrinol Metab, 81, pp.2742~2745 (1996)
- Pearce EN, "Thyroid dysfunction in perimenopausal and postmenopausal women", Menopause Int, 13, pp.8~13 (2007)
- Mitrou P, "Thyroid disease in older people", Maturitas, 70, pp.5~9 (2011)
- Schindler AE, "Thyroid function and postmenopause", Gynecol Endocrinol, 17, pp.79~85 (2003)
- Sowers M, "Thyroid stimulating hormone (TSH) concentrations and menopausal status in women at the mid-life: SWAN", Clin Endocrinol (Oxf), 58, pp.340~347 (2003)
- Arafah BM, "Increased need for thyroxine in women with hypothyroidism during estrogen therapy", N Engl J Med, 344, pp.1743~1749 (2001)