Background

Thyroid gland dysfunction represents an epidemiologically relevant disease in the female gender, where treatment with oral contraceptives (OCs) is frequently prescribed. Although OCs are able to impact the thyroid gland function, scanty data have been released on this matter so far.

Aim

The aim of this article was to review how hormonal OCs, including estrogen- or progesterone-only containing medications, interact with the hepatic production of thyroid-binding globulin (TBG) and, consequently, their effects on serum levels of thyroxine (T4) and triiodothyronine (T3). We also reviewed the effect of Levo-T4 (LT4) administration in women taking OCs and how they influence the thyroid function in both euthyroid women and in those receiving LT4.

Review

The estrogenic component of the pills is capable of increasing various liver proteins, such as TBG, sex hormone-binding protein (SHBG) and coagulation factors. On the other hand, the role of progestogens is to modulate estrogen-dependent effects mainly through their anti-androgenic action. In fact, a reduction in the effects of androgens is useful to keep the thromboembolic and cardiovascular risks low, whereas OCs increase it especially in women with subclinical hypothyroidism or in those treated with LT4. Accordingly, subclinical hypothyroidism is known to be associated with a higher mean platelet volume than normal and this increases cardiovascular risk due to platelet hyperactivity caused by incomplete thrombocytopoietic maturation.

中文翻译：

---

口服避孕药对甲状腺功能的影响，反之亦然。

背景

甲状腺功能障碍是女性的一种流行病学相关疾病，经常开具口服避孕药（OCs）。尽管OCs能够影响甲状腺功能，但到目前为止，有关此问题的数据很少。

目标

本文的目的是探讨激素性OC，包括仅含雌激素或孕激素的药物如何与甲状腺结合球蛋白（TBG）的肝脏产生相互作用，以及因此，它们对甲状腺素（T4）和三碘甲状腺素（T3）。我们还回顾了左旋-T4（LT4）给药对服用OC的女性的影响，以及它们如何影响正常甲状腺女性和接受LT4的女性的甲状腺功能。

评论

药丸的雌激素成分能够增加各种肝脏蛋白，例如TBG，性激素结合蛋白（SHBG）和凝血因子。另一方面，孕激素的作用主要是通过其抗雄激素作用来调节雌激素依赖性作用。实际上，减少雄激素的作用有助于降低血栓栓塞和心血管疾病的风险，而OCs尤其在患有亚临床甲状腺功能减退症的女性或接受LT4治疗的女性中使OCs升高。因此，已知亚临床甲状腺功能减退症患者的平均血小板体积比正常人高，这会由于血小板生成不完全所引起的血小板过度活跃而增加心血管疾病的风险。