EMAS position statement: Thyroid disease and menopause

Gesthimani Mintziori; Stavroula Veneti; Kris Poppe; Dimitrios G Goulis; Eleni Armeni; C Tamer Erel; Ivan Fistonić; Timothy Hillard; Angelica Lindén Hirschberg; Blazej Meczekalski; Nicolás Mendoza; Alfred O Mueck; Tommaso Simoncini; Petra Stute; Dorenda van Dijken; Margaret Rees; Leonidas Duntas; Irene Lambrinoudaki

doi:10.1016/j.maturitas.2024.107991

EMAS position statement: Thyroid disease and menopause

Maturitas. 2024 Apr 24:185:107991. doi: 10.1016/j.maturitas.2024.107991. Online ahead of print.

Authors

Gesthimani Mintziori¹, Stavroula Veneti², Kris Poppe³, Dimitrios G Goulis², Eleni Armeni⁴, C Tamer Erel⁵, Ivan Fistonić⁶, Timothy Hillard⁷, Angelica Lindén Hirschberg⁸, Blazej Meczekalski⁹, Nicolás Mendoza¹⁰, Alfred O Mueck¹¹, Tommaso Simoncini¹², Petra Stute¹³, Dorenda van Dijken¹⁴, Margaret Rees¹⁵, Leonidas Duntas¹⁶, Irene Lambrinoudaki¹⁷

Affiliations

¹ Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. Electronic address: gefsi@auth.gr.
² Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
³ University Hospital CHU St-Pierre UMC, Université libre de Bruxelles (ULB), Belgium.
⁴ Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece and Royal Free Hospital, London, United Kingdom.
⁵ Istanbul-Cerrahpaşa University, Cerrahpaşa School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.
⁶ Faculty for Health Studies, University of Rijeka, Rijeka, Croatia.
⁷ Department of Obstetrics and Gynaecology, University Hospitals Dorset, Poole, UK.
⁸ Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
⁹ Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
¹⁰ Department of Obstetrics and Gynecology, University of Granada, Spain.
¹¹ Department of Women's Health, University Hospital Tuebingen, Germany; Beijing OB/GYN Hospital, Capital Medical University, China.
¹² Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy.
¹³ Department of Obstetrics and Gynecology, University Clinic Inselspital, Bern, Switzerland.
¹⁴ Department of Obstetrics and Gynecology, OLVG Hospital, Amsterdam, The Netherlands.
¹⁵ Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
¹⁶ Evgenideion Hospital, Unit of Endocrinology and Metabolism, National and Kapodistrian University, Athens, Greece.
¹⁷ Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece.

PMID: 38658290
DOI: 10.1016/j.maturitas.2024.107991

Abstract

Introduction: Thyroid diseases are common in women in their late reproductive years; therefore, thyroid disease and menopause may co-exist. Both conditions may present with a wide range of symptoms, leading to diagnostic challenges and delayed diagnosis. Aim To construct the first European Menopause and Andropause Society (EMAS) statement on thyroid diseases and menopause.

Materials and methods: Literature review and consensus of expert opinion (EMAS executive board members/experts on menopause and thyroid disease).

Summary recommendations: This position paper highlights the diagnostic and therapeutic dilemmas in managing women with thyroid disease during the menopausal transition, aiming to increase healthcare professionals' awareness of thyroid disorders and menopause-related symptoms. Clinical decisions regarding the treatment of both conditions should be made with caution and attention to the specific characteristics of this age group while adopting a personalized patient approach. The latter must include the family history, involvement of the woman in the decision-making, and respect for her preferences, to achieve overall well-being.

Keywords: Hyperthyroidism; Hypothyroidism; Menopause; Thyroid.