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The Link Between PCOS and Hypothyroidism

Polycystic ovary syndrome (PCOS) is one of the the most common hormonal disorders among women of reproductive age. Infertility can be one of the main symptoms of PCOS symptoms as well as cysts, or fluid-filled sacs, on the ovaries. Many women with PCOS also present with irregular menstrual cycles, problems with insulin resistance and obesity, as well as higher amounts of male hormones that contribute to excessive body or facial hair.

Women with PCOS also typically have a higher risk of developing hypothyroidism or Hashimoto’s (autoimmune) thyroiditis. In one study, 22.5% of women with PCOS had hypothyroidism as compared to 8.75% in controls (1). A more recent study published in Endocrine Research demonstrated a higher prevalence of Hashimoto’s thyroiditis, elevated TSH, and elevated thyroid antibodies (anti-TPO and anti-Tg) in PCOS patients (2). The researchers suggested an increased estrogen and estrogen/progesterone ratio to be directly involved in the higher antibody levels in PCOS patients. Not only is the incidence of hypothyroidism and Hashimoto’s thyroiditis higher in PCOS patients, but low thyroid itself can worsen PCOS symptoms. One example of hypothyroidism impacting PCOS symptoms is through lowering sex hormone binding globulin (SHBG), which leads to elevated testosterone, increasing the androgenic symptoms of PCOS including acne and increased facial or body hair. PCOS and hypothyroidism often have similar symptoms as well, making it important to check for and rule out hypothyroidism if PCOS is suspected/diagnosed. Symptoms that both conditions can have in common include:

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If you or someone you know has been diagnosed with PCOS, it is important to evaluate whether they have hypothyroidism or Hashimoto’s thyroiditis as well. Without a well functioning thyroid, PCOS symptoms can be exacerbated and the hormonal imbalances can be difficult to stabilize.

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  1. Sinha U, Sinharay K, Saha S, Longkumer TA, Baul SN, Pal SK. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India. Indian J Endocrinol Metab. 2013 Mar; 17(2):304-9.

  2. Arduc A, Dogan BA, Bilmez S, Imga Nasiroglu N, Tuna MM, Isik S, Berker D, Guler S. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role? Endocr Res. 2015 Mar 30:1-7.

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