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Wybrane endokrynopatie w menopauzie – wskazówki praktyczne dotycz ce diagnostyki

Keywords: menopause , hypothyroidism , hyperthyroidism , diabetes mellitus type 2 , thyroid-stimulating hormone , free thyroxine , oral glucose tolerance test

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Abstract:

The paper presents practical guidelines in diagnosing the most frequent endocrinopathies in menopausalwomen. The frequency of thyroid disorders and type 2 diabetes rises with age and the hormones in theperimenopausal period create favourable conditions for the development of such endocrinopathies. Clinicalpicture, often mildly symptomatic, may resemble menopausal symptoms and their variety may mask theclinical picture of different cases of endocrinopathy, which makes the right diagnosis difficult to establish andcauses medical problems that require interdisciplinary cooperation of many different specialists. The questionof diagnostic screening tests still seems to be an unresolved issue. Some authors opt for routine thyroiddiagnostics, while others recommend only detailed case finding with the assessment of risks factors in thepost-menopausal period. The authors of this paper suggest that every perimenopausal woman should undergothyroid tests and the presence of goitre should be a recommendation for detailed thyroid diagnostics includingimaging. Taking into consideration natural development of type 2 diabetes together with a multidirectionalcharacter of pathogenic disorders induced by menopause, it seems that an oral glucose tolerance test (OGTT)rather than a fasting glucose test should serve as a primary diagnostic parameter.

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