The Effect Of Long-term Thyroid-stimulating Hormone Suppressive Therapy On The Gonadal Steroid Hormones Of Patients After Surgery For Thyroid Cancer

Objective :To analyze the effect of long-term thyroid-stimulating hormone suppressive therapy and the surgery for thyroid cancer on the gonadal steroid hormones and related symptoms in patients by postoperative follow-up.Method:Totally 238 patients who underwent thyroid surgery and subsequent TSH supression treatment in Department of thyroid Surgery, China-Japan Union hospital, Jilin University,were enrolled, but excluded surgical menopause,then collective the postoperative follow-up data(3-8 years).Operational method, pathological diagnosis, postoperative radioiodine therapy, the time and dose of TSH supression treatment,the menstrual cycle,period,menstruation quantity, with dysmenorrhea and menstrual disorder or not, the date of last menstrual period,menopausal age, and the related hormones were tested. Estradiol and testosterone were tested in males and Also include follicle stimulating hormone in females,and all patients were tested for TSH,FT3,FT4. Groups were divided into three groups according to different period and levels of TSH(TSH<0.1IU/L、0.1IU/L≤TSH<0.5IU/L�'� TSH≥0.5IU/L).,and two groups acording to time of suppression therapy(3-5years and 6-8years).Females can be further divided into sexual maturity,menopausal transition,perimenopause,which sexual maturity females is divided into folliclllar phase, ovulation and luteal phase according to the ovarian cycle;perimenopause females divided into preoperative menopausal and postmenopausal.Results:1)The time of TSH supression treatment and level of TSH has no effect on estradiol and testosterone in males with thyroid cancer after surgery. 2) The time of TSH supression treatment has no effect on testosterone in females with thyroid cancer after surgery at the same level of TSH.In the group of treatment time for 3-5 years,the testosterone levels is the lowest when TSH≥0.5IU/L, and there was a significant difference of testosterone levels between group TSH ≥ 0.5IU/L and 0.1IU/L ≤ TSH < 0.5IU/L(P = 0.001). In postmenopausal patients, The time of TSH supression treatment and level of TSH has no obvious influence on estradiol and follicle stimulating hormone.In the sexual maturity female patients, the effects of estradiol is mainly reflected in the group of 0.1IU/L≤TSH<0.5IU/L, lesser ingroup of 3-5 years than 5-8 years(P = 0.018). The time of TSH supression treatment and level of TSH had noeffect on follicle stimulating hormone in females.3) There were no difference of menopausal age,hormone levels of E2,T,FSH,TSH,operational method, postoperative radioiodine therapy or not and the risk stratification between group preoperative menopausal and postmenopausal. The time of2)TSH supression treatment and level of TSH has no effects on the menstrual blood volume, with dysmenorrhea and menstrual disorder or not.Conclusion:The time of TSH supression treatment and level of TSH after thyroid opreation has incluence on testosterone and estradiol of sexual maturity females.,and no incluence on testosterone and estradiol of males,follicle-stimulating hormone of females.No affections of menopause age and menstruation in women are found after thyroid operaton and TSH supression treatment.