5 Things Women With PCOS Should Know About Hypothyroidism

Polycystic ovary syndrome (PCOS) and thyroid problems are two of the most common but potentially overlooked endocrine (hormonal) disorders in women.Although PCOS and Hypothyroidism (Hypothyroidism) PCOS is very different and they share many features.

This article takes a closer look at five things people with PCOS should know about hypothyroidism. This includes understanding what a diagnosis of hypothyroidism involves and what is needed to avoid thyroid-related complications of PCOS.

Hypothyroidism in women with polycystic ovary syndrome

hypothyroidism, especially Hashimoto’s Thyroiditis, is more common in PCOS patients than in the general population. Hashimoto’s is an autoimmune disease in which the body attacks and damages the thyroid gland, leading to hypothyroidism.

A 2013 Indian study found that 22.5% of women with PCOS had hypothyroidism, compared with 8.75% of women without PCOS.

A 2015 study by the National Institutes of Health reported that 22.1 percent of women with PCOS had Hashimoto’s thyroiditis, compared with 5 percent of women without it.


Hypothyroidism, especially the autoimmune disease Hashimoto’s thyroiditis, occurs three to four times more frequently in women with PCOS than in women without PCOS.

How hypothyroidism worsens PCOS

Hypothyroidism is known to affect the ovaries in a similar manner to PCOS, leading to ovarian enlargement and cyst formation.

Hypothyroidism tends to make PCOS symptoms worse, including an increased risk of insulin resistance (the inability of the body to use insulin to control blood sugar) and type 2 diabetes.

Hypothyroidism can also increase the production of the male hormone testosterone (called hyperandrogenism).This increases the risk of PCOS-related symptoms such as acne, male pattern baldness and hirsutism (abnormal facial or body hair). Hyperandrogenism can also cause menstrual irregularities.

Too much testosterone can also interfere with the development of follicles (the sacs in the ovaries where eggs develop) and prevent normal ovulation (the release of mature eggs).


Hypothyroidism can exacerbate the symptoms of PCOS, including increased insulin resistance, irregular menstruation, abnormal hair growth, and male pattern baldness. It also affects ovulation and the normal development of eggs.

How hypothyroidism complicates PCOS

The butterfly-shaped thyroid gland, located at the base of the throat, regulates the rate at which the body converts food into energy (called metabolism). Thyroid hormones also help control your heart rate and affect your menstrual cycle and fertility.

If your thyroid is working too slowly (hypothyroidism), your metabolism can slow down, leading to weight gain. Weight gain is a core characteristic of many women with PCOS.

Hypothyroidism can also complicate PCOS, causing symptoms that are not usually present with the disease.This includes bradycardia (slowed heart rate), facial swelling (“moon face”), and goiter (enlarged thyroid gland).


In addition to worsening the symptoms of PCOS, hypothyroidism can cause symptoms that are not common in PCOS. These include abnormally slowed heart rate, facial “moon” and goiter (enlarged thyroid gland),

Why Hypothyroidism is Missed

Thyroid-stimulating hormone (TSH) is a hormone produced by the pituitary gland that regulates the release of the thyroid hormones T3 and T4.

An abnormally high TSH level indicates that you may have hypothyroidism. This is because the pituitary gland is working overtime to stimulate the underactive thyroid gland.

Even so, a high TSH by itself does not mean you have hypothyroidism. Diagnosis also requires a series of T3 and t4 tests and an anti-TPO test to check if you have an autoimmune thyroid disease like Hashimoto’s.

Because hypothyroidism is often difficult to diagnose, it is often misdiagnosed in women with PCOS.


Hypothyroidism can be difficult to diagnose and may be missed in women with PCOS unless a complete diagnostic evaluation is performed. By itself, high TSH levels do not diagnose hypothyroidism.

Iodine plays an important role

The thyroid must have iodine to make thyroid hormones. Major food sources of iodine include dairy products, chicken, beef, pork, fish, and iodized salt.

A moderate amount of iodine is required to keep T3 and T4 production in balance. Too little or too much can cause or worsen hypothyroidism.

For this reason, women with PCOS who have been diagnosed with (or are at risk of developing hypothyroidism) need to pay special attention to their iodine intake. Doing so minimizes the effects of hypothyroidism, which in turn minimizes the impact of hypothyroidism on PCOS.


Women with PCOS and hypothyroidism need to be mindful of their iodine intake to ensure they are neither getting too much nor too little. Any impact on PCOS can be minimized by better management of hypothyroidism.


Hypothyroidism (underactive thyroid) is common in women with PCOS. This includes an autoimmune disease called Hashimoto’s thyroiditis.

Not only does hypothyroidism exacerbate the symptoms of PCOS (including weight gain, irregular menstruation, and increased insulin resistance), but it can also cause symptoms that are less common in PCOS. These include goiter (enlarged thyroid gland), facial puffiness, and bradycardia (abnormally slow heart rate).

Diagnosing hypothyroidism can be tricky and sometimes missed in women with PCOS. If diagnosed, hypothyroidism needs to be managed appropriately to minimize its impact on PCOS. This includes proper iodine intake.