Hormonii tiroidieni şi axul gonadal hipotalamo-hipofizar feminin

Abstract

Introducere. Afecţiunile tiroidiene reprezintă un dezechilibru hormonal, cu consecinţe semnificative asupra stării reproductive şi metabolice la femei. Prin urmare, tulburări precum hipotiroidismul sau bolile autoimune tiroidiene afectează funcţia axului gonadal hipotalamo-hipofizar perturbând circuitul hormonal la femei. Scop. Studierea mecanismelor prin care deficitul hormonilor tiroidieni provoacă disfuncţia axului gonadal hipotalamo-hipofizar la diferite nivele şi perturbă funcţia reproductivă la femei. Material şi metode. Prin intermediul datelor din literatură au fost analizate mecanismele prin care hormonii tiroid-ieni influenţează în mod direct sau indirect axul hipotalamo-hipofizar gonadal feminin. Literatura de specialitate utilizată a fost selectată din perioada 2020-2025 publicată în PubMed, Medline, Google Scholar, MedScape, Library, Scopus, Research Gate. Rezultate. Hormonii tiroidieni influenţează pleiotropic axul gonadal feminin, prin modularea secreţiei de kisspeptină, GnRH şi administrarea disponibilităţii steroizilor sexuali prin modificări ale proteinelor de transport. Hormonii tiroidieni şi axul gonadal hipotala-mo-hipofizar sunt interconectaţi prin prisma unor semnale energetice şi hormonale, precum leptina, insulina şi pro-lactina. Prin urmare, deficitul de hormoni tiroidieni poate provoca disfuncţii ale procesului pubertal, infertilitate şi sindromul ovarelor polichistice. Astfel, depistarea timpurie a tulburărilor hormonale tiroidiene ar putea preveni dezvoltarea afecţiunilor reproductive. Concluzii. Cunoaşterea detaliată a mecanismelor prin care hormonii tiroidieni influenţează axa hipotalamo-hipofizară gonadală la diferite nivele, potenţează o gestionare clinică corectă prin înaintarea unui tratament eficient şi reducerea efectelor adverse asupra sistemului reproductiv feminin.

Introduction. Thyroid disorders represent a hormonal imbalance with significant consequences on reproductive and metabolic health in women. Conditions such as hypothyroidism or autoimmune thyroid diseases affect the function of the hypothalamic-pituitary-gonadal (HPG) axis, disrupting the hormonal balance in females. Objective. The investigation of the mechanisms through which thyroid hormone deficiency causes dysfunction of the HPG axis at different levels and impairs female reproductive function. Material and methods. Based on literature data, the mechanisms by which thyroid hormones directly or indirectly influence the Hypothalamic-Pituitary-Gonadal axis were analyzed. The specialized literature used was selected from the period 2020-2025 published on subject in PubMed, Medline, Google Scholar, MedScape, Library, Scopus, and Research Gate. Results. Thyroid hormones pleiotropically influence the female gonadal axis by modulating the secretion of kisspeptin, GnRH, and by regulating the bioavailability of steroids through changes in transport proteins. The thyroid hormones and the Hypothalamic-Pituitary-Gonadal axis are interconnected via energy and hormonal signals such as leptin, insulin, and prolactin. Consequently, thyroid hormone deficiency can lead to disruptions in pubertal development, infertility, and polycystic ovary syndrome (PCOS). Therefore, early detection of thyroid hormonal imbalances may help prevent the development of reproductive disorders in females. Conclusion. A detailed understanding of the mechanisms by which thyroid hormones influence the Hypothalamic-Pituitary-Gonadal axis at various levels supports accurate clinical management through the implementation of effective treatment and reduction of adverse effects on the female reproductive system.