Influence de la ménopause sur les variations endocriniènnes chez les patientes atteintes de goitre.

Abstract

This cross-sectional study was conducted on a Mostaganem population of 200 Algerian women with goiter, aged under 50 and between 50 to over 65 years. Participants were classified according to their physiological status (pre-menopausal and post-menopausal women) as well as the functional type of goiter (euthyroid, hypothyroid, and hyperthyroid). The main objective was to evaluate the influence of menopause on variations in thyroid hormones, gonadotropins, and glucose metabolism parameters using the Cobas E411 analyzer. Statistical analysis was performed using two-way ANOVA and Newman–Keuls test. The results show that thyroid hormones are mainly influenced by the type of goiter (P<0.01), while menopause has no significant effect. Hypothyroid patients presented elevated TSH with decreased FT3 and FT4, whereas hyperthyroid patients showed the opposite profile. This confirms the role of hypothalamic–pituitary feedback and the relative independence of the thyroid axis from menopause. Regarding gonadotropins, menopause caused a highly significant increase in FSH and LH, along with a decrease in testosterone (P<0.01). These variations reflect the cessation of ovarian activity and the removal of estrogenic feedback. Thyroid status did not influence these hormones. On the metabolic level, a significant increase in blood glucose was observed after menopause, suggesting insulin resistance linked to estrogen deficiency. HbA1c was more influenced by thyroid status, with higher values in hyperthyroid women. Apparently, menopause mainly affects the gonadotropic axis and blood glucose, while thyroid dysfunctions are primarily related to thyroid hormones and HbA1c. These findings highlight the importance of an integrated endocrine–metabolic management approach in postmenopausal women.