A descriptive cross-sectional study of association between abnormal uterine bleeding and thyroid dysfunction
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251576Keywords:
Hypothyroid, Hyperthyroid, Abnormal uterine bleeding, Menstrual patterns, Thyroid function testAbstract
Background: Abnormal uterine bleeding (AUB) is one of the most common gynecological presentation, accounting for at least 20% of all outpatient visits. Thyroid dysfunction has profound effect on the female reproductive system. Both hypothyroidism and hyperthyroidism are associated with untoward menstrual changes. This study aims to find the prevalence of thyroid dysfunction among patients with diagnosed AUB.
Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at General Hospital Jayanagar, Bengaluru. After taking ethical clearance from the Institutional Review Committee, the study was conducted on 100 patients with AUB satisfying the inclusion and exclusion criteria from November 2020 to May 2022. Thyroid function test was done in all patients by radioimmunoassay on an automated analyzer. Data was collected using a questionnaire which includes patient’s profile, pattern of AUB, examination and thyroid profile.
Results: Out of 100 patients, it was found that 75% were euthyroid, 20% were hypothyroid, among which 15% had subclinical hypothyroidism and 5% had overt hypothyroidism and 5% were hyperthyroidism. The most common type of AUB was menorrhagia in 38%, followed by acyclical bleeding in 33%, polymenorrhoea in 11%, metrorrhagia in 8%, oligomenorrhoea in 7%, and hypomenorrhea in 3%. The maximum number of patients were between 30-40 years.
Conclusions: Thyroid dysfunction is one of the important causes of AUB with hypothyroidism being the most common type in patients with menorrhagia. It was reported that their symptoms improved with thyroid medication.
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References
ACOG Committee on Practice Bullentins-Gynaecology, American College of Obstetricians and Gynaecologists. ACOG practice bulletin: management of anovulatory bleeding. Int J Gynaecol Obstet. 2001;72(3):263-71.
Nesse RE. Abnormal vaginal bleeding in peri-menopausal women. Am Family Physician. 1989;40(1):185-92.
Ali J, Das KK, Konyak P. Study of relation of thyroid profile with abnormal uterine bleeding. Sch J App Med Sci. 2015;3(7D):2688-92.
Bhardwaj M, Modi J, Agarwal V. Study of thyroid function in dysfunctional uterine bleeding. Nat J Med Dent Res. 2015;4(1):6-10.
Dittrich R, Beckmann MW, Oppelt PG, Hoffmann I, Lotz L, Kuwert T, et al. Thyroid hormone receptors and reproduction. J Reprod Immunol. 2011;90(1):58-66. DOI: https://doi.org/10.1016/j.jri.2011.02.009
Rifai N, Horvath AR, Wittwer CT, editors. Tietz textbook of clinical chemistry and molecular diagnostics. 6th Edition. St. Louis: Elsevier. 2018;627.
Barnard K, Frayne SM, Skinner KM, Sullivan LM. Health status among women with menstrual symptoms. J Womens Health (Larchmt). 2003;12(9):911-9. DOI: https://doi.org/10.1089/154099903770948140
Cote I, Jacobs P, Cumming D. Work loss associated with increased menstrual loss in the United Stated. Obstet Gynecol. 2002;100:683-7. DOI: https://doi.org/10.1097/00006250-200210000-00012
Millar WJ. Hysterectomy, 1981/82 to 1996/97. Health Rep. 2001;12(2):9-22. DOI: https://doi.org/10.1016/S0363-8111(96)90097-1
Frick KD, Clark MA, Steinwachs DM, Langenberg P, Stovall D, Munro MG, et al. Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment. Womens Health Issues. 2009;19(1):70-8. DOI: https://doi.org/10.1016/j.whi.2008.07.002
Ramalho I, Leite H, Aguas F. Abnormal uterine bleeding in adolescents: a multidisciplinary approach. Acta Med Port. 2021;34(4):291-7. DOI: https://doi.org/10.20344/amp.12829
Kouides PA. Menorrhagia from a haematologist's point of view. Part I: initial evaluation. Haemophilia. 2002;8(3):330-8. DOI: https://doi.org/10.1046/j.1365-2516.2002.00634.x
Michiels JJ, Schroyens W, Berneman Z, van der Planken M. Acquired von Willebrand syndrome type 1 in hypothyroidism: reversal after treatment with thyroxine. Clin Appl Thromb Hemost. 2001;7(2):113-5. DOI: https://doi.org/10.1177/107602960100700206
Joshi BR, Rizal S, Subedi S. Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021;59(239):635-9. DOI: https://doi.org/10.31729/jnma.6487
Kazerouni F, Amirrasouli H. Performance characteristics of three automated immunoassays for thyroid hormones. Caspian J Intern Med. 2012;3(2):400-4.
Aryal M, Gyawali P, Rajbhandari N, Aryal P, Pandeya DR. A prevalence of thyroid dysfunction in Kathmandu University Hospital, Nepal. Biomed Res. 2010;21(4):411-5.
Kattel P, Baral G. Thyroid function test in abnormal uterine bleeding. Nepal J Obstet Gynaecol. 2017;23(2):74-8. DOI: https://doi.org/10.3126/njog.v12i2.19959
Rai A, Raina S. A study of prevalence of thyroid dysfunction in abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2020;9:2905-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20202731
Sahu R, Rath SK. Thyroid disorders in reproductive age presenting with abnormal uterine bleeding. Indian J Obstet Gynecol Res. 2021;8(2):259-63. DOI: https://doi.org/10.18231/j.ijogr.2021.053
Hema KR, Girish BL, Dhananjaya BS, Kalaburgi RA. Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age. Int J Reprod Contracept Obstet Gynecol. 2020;9:2792-6. DOI: https://doi.org/10.18203/2320-1770.ijrcog20202710
Bedi M, Khosa SK, Das I, Khaira HK, Gupta K. Evaluation of Thyroid Hormone Profile in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc. 2020;8(1):37-41. DOI: https://doi.org/10.5005/jp-journals-10032-1205