Image: Medline Plus

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

“When was the last time you had your thyroid checked?” the nurse practitioner asked me. I was at my annual exam, discussing heavy menstrual bleeding.

“I’m not sure,” I replied. “Maybe never?”

Really, I was thinking to myself, What’s a thyroid?

As it turns out, the thyroid gland does a lot of the work that regulates the body’s metabolism, which is sort of a big deal for overall health. It means that when the thyroid is overactive — as in the case of hyperthryoidism — or when the thyroid is underactive — as in the case of hypothyroidism — symptoms can show up in a variety of areas, such as:

• Body temperature. Sensitivity to cold is one symptom of hypothyroidism while heat intolerance (especially important in Arizona in the summer!) can be a hyperthyroid symptom.
• Weight changes. Folks with hyperthyroidism may experience unexplained weight loss or the inability to maintain body weight. People with hypothyroidism may experience unexplained weight gain or the inability to lose weight.
• Mental health concerns. Hypothyroidism is associated with depression, as well as the fatigue and muscle pain that may accompany it; hyperthyroidism is associated with nervousness, irritability, and anxiety.
• Menstruation. Though this only applies to people who menstruate, those with hyperthyroidism may experience lighter, less frequent menstrual periods while those with hypothyroidism may experience both irregular cycles and heavier menstrual bleeding.

Particularly because of that last symptom, healthy thyroid function is important for sexual and reproductive health. It’s not terribly uncommon for patients to ask providers to go on hormonal birth control in order to tame unwieldy bleeding or to regulate unpredictable cycles. Unfortunately, as I discovered, it’s also not uncommon to be prescribed birth control pills for difficult-to-manage periods without testing for what might be causing the symptoms in the first place.

Left untreated, hypothyroidism can contribute to complications like high cholesterol and heart disease, nerve damage, infertility, and birth defects. Hyperthyroid complications include tachycardia (rapid heart rate) and congestive heart failure, osteoporosis, and something called thyrotoxic crisis — an emergency situation where symptoms become rapidly worse.

This is not to scare people or convince them that everyone needs to have their thyroid function tested immediately. In fact, the U.S. Preventive Services Task Force found insufficient evidence to recommend for or against routine thyroid screening, though some other health care associations do. (The American Thyroid Association recommends screening every five years beginning at age 35, and the American Association of Clinical Endocrinologists recommends routine screening either before a person becomes pregnant or else in the first trimester of pregnancy.) However, particularly for people who have unexplained symptoms associated with thyroid conditions or who are at increased risk for developing thyroid disease, having knowledge of and access to such screening is an invaluable health tool.

If you’d like to discuss thyroid screening with a health care provider, you can make an appointment at your local Planned Parenthood health center.