Association of Thyroid Disorders in reproductive age presenting with abnormal uterine bleeding
International Journal of Clinical Obstetrics and Gynecology: Published 2021
Abnormal uterine bleeding is defined
as any type of bleeding that is abnormal in volume, frequency, duration and
periodicity. Frequent complaints include heavy and prolonged menstrual
bleeding with or without pain, passage of clots, fatigue and lethargy.
AUB is one of the frequent
presentation in gynecological OPD, occurs in 15-20% women between menarche to
menopause.
This may significantly affect the
quality of life, results in time off work, lead to surgical
interventions including hysterectomy, and ultimately have a significant
impact on the health care system.
The aim is to study the association
of bleeding pattern with thyroid dysfunction among patients with Abnormal
Uterine Bleeding (AUB).
TAKE HOME MESSAGE
Abnormal menstruation like
menorrhagia, oligomenorrhoea and polymenorrhoea outside the normal parameters
is one of the most common manifestations of hypothyroidism affecting the
females.
Thyroid disorders, such as
hypothyroidism and hyperthyroidism are associated with late onset puberty,
anovulatory cycles and abnormally high incidence of foetal morbidity and
mortality.
This abnormal uterine bleeding can
be best diagnosed by taking personal and family history of the patient with
good clinical examination. Estimation of various endocrine hormones like
Thyroid Function test, Prolactin, Follicle stimulating hormone (FSH),
Luteinizing hormone (LH) and hemoglobin is important for assessment of abnormal
uterine bleeding.
The bleeding abnormality that is
found most of the women is polymenorrhagia and menorrhagia. 32% of patients who
were studied, had thyroid dysfunction, of which 18% of patients had subclinical
hypothyroidism, 11% of patients had hypothyroidism and only 3% of patients had
hyperthyroidism.
Conclusion
Abnormal uterine bleeding has a
strong association with thyroid disorders. The most common type of disorder is
subclinical hypothyroidism then hypothyroidism. Thus, all patient of AUB must
be evaluated for thyroid dysfunction.
Study concludes that thyroid
dysfunction should be considered as an important etiological factor for
menstrual abnormality especially during fertile period while evaluating cases
of AUB.
These patients with thyroid dysfunction, if given medical treatment, it is possible to avoid unnecessary hormonal treatment and costly surgical interventions.
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Background: Abnormal uterine bleeding from the vagina that
usually occurs when ovary do not release egg and if it occurred during fertile
years leads to various complication like anemia, Infertility etc. and among all
causes one of the most common cause of abnormal uterine bleeding is disturbance
in level of Thyroid hormones.
Methods: 100 female Patients of age group between 20-45 having
complain of Abnormal uterine bleeding visited at Gynec OPD of our institute
were included in this study. Fasting blood samples was taken from all
participants and samples were analyzed for Thyroid function test (TSH, T3, T4)
at central laboratory of our hospital. Obtained data was analyzed statistically
by using prizam software.
Results: The bleeding abnormality that is found most of the women is
polymenorrhagia and menorrhagia.32% of patients who were studied, had thyroid
dysfunction, of which 18% of patients had subclinical hypothyroidism, 11% of
patients had hypothyroidism and only 3% of patients had hyperthyroidism.
Conclusions: Our study concludes that thyroid dysfunction should
be considered as an important etiological factor for menstrual abnormality
especially during fertile years.
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