Journal Health of Woman. 2026. 3(184): 5-13. doi: 10.15574/HW.2026.3(184).513

Vitiuk A. D.¹, Gorbunova O. V.², Sakaly L. I.²
¹PHEI “Dobrobut Academy”, Kyiv, Ukraine
²Shupyk National Healthcare University of Ukraine, Kyiv

For citation: Vitiuk AD, Gorbunova OV, Sakaly LI. (2026). Clinical and reproductive determinants of contraceptive choice in women with thyroid dysfunction under chronic war-related stress: rationale for a personalized algorithm. Ukrainian Journal Health of Woman. 3(184): 5-13. doi: 10.15574/HW.2026.3(184).513
Article received: May 03, 2026. Accepted for publication: Jun 01, 2026.

Thyroid dysfunction in women of reproductive age may be associated with menstrual disturbances, psycho-emotional changes, and the need for individualized contraceptive counseling. Under chronic war-related stress, these factors become more relevant because of postponed pregnancy, unstable reproductive plans, and limited access to medical follow-up.
Aim – to substantiate a differentiated approach to contraceptive choice in women of reproductive age with thyroid dysfunction under chronic war-related stress.
Materials and methods. A clinical analytical study included 105 women with thyroid dysfunction. Group I comprised 32 women with hypothyroidism or subclinical hypothyroidism; Group II, 28 with hyperthyroidism, a history of thyrotoxicosis, or unstable thyroid status; and Group III, 45 with autoimmune thyroiditis and a euthyroid or subclinically altered thyroid profile. Reproductive plans, menstrual function, stress burden, contraceptive history, clinical acceptability of methods, and adherence-related factors were assessed.
Results. Ninety-six women (91.4%) did not plan pregnancy within the next 12 months, and 99 (94.3%) required effective contraception. Menstrual cycle disturbances were identified in 76 patients (72.4%). Pronounced stress burden was more frequent in Group II. Contraceptive choice required consideration of thyroid status, menstrual phenotype, psycho-emotional burden, reproductive plans, adherence, and access to follow-up.
Conclusions. Thyroid dysfunction itself is not a reason to restrict modern contraceptive methods. The proposed personalized algorithm includes sequential assessment of reproductive plans, thyroid status, menstrual function, psycho-emotional state, risk of low adherence, need for dual protection, and feasibility of follow-up.
The study was conducted in accordance with the Declaration of Helsinki. All participants provided informed consent. T
The authors declare no conflict of interest.
Keywords: thyroid dysfunction, contraception, hypothyroidism, hyperthyroidism, autoimmune thyroiditis, war-related stress, menstrual cycle, personalized algorithm.

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