The association of thyroid disorders with abnormal uterine bleeding

Prasad Yeshwant Deshmukh, B. G. Boricha, Ankita Pandey


Background: Dysfunctional uterine bleeding is an abnormal bleeding from the uterus in absence of organic disease of genital tract and demonstrable extragenital cause. Thyroid dysfunction is marked by large number of menstrual aberrations. This study is aimed at detecting thyroid dysfunction in patients with provisional diagnosis of AUB and refers positive cases to physician for further evaluation.

Methods: 100 cases of clinically diagnosed AUB were taken from Gynaecology OPD and inpatients of MGM hospital, Kalamboli. All patients from 19 to 45 age groups presenting as menorrhagia, acyclical metropathia, polymenorrhagia, metrorhhagia, oligomenorrhoea, polymenorrhoea and hypomenorrhoea were tested for their thyroid function by T3, T4, TSH estimations in their serum. Patients who had clinical signs and symptoms of thyroid disease, were on hormonal treatment, IUCD users, or had bleeding disorders were excluded from the study.

Results: 30% of patients who were studied had thyroid dysfunction, of which 18% of patients had subclinical hypothyroidism, 9% of patients had hypothyroidism and only 3% of patients had hyperthyroidism. The commonest bleeding abnormalities in subclinical hypothyroid patients were polymenorrhaggia and menorrhaggia. Most of the hyperthyroid cases were oligomenorrhoeic.

Conclusions: Both subclinical hypothyroid and profoundly hypothyroid cases together were the commonest thyroid dysfunction and menorrhagia was their commonest menstrual abnormality. So this study concludes that, biochemical evaluation of thyroid functioning should be made mandatory in all provisionally diagnosed cases of DUB to detect thyroid dysfunction. 


Dysfunctional uterine bleeding, Abnormal uterine bleeding, Thyroid dysfunction, Hypothyroidism, Subclinical hypothyroidism, Hyperthyroidism, Menstrual disorders

Full Text:



John Thompson, Jeferey Warshaw. Hysterectomy. In: John Rock, eds. Te Linde’s Operative Gynecology. 8th ed. Philadelphia: Lippincott Williams and Wilkins Company; 1997: 771-854.

El-Hemaidi I, Gharaibeh A, Shehata H. Menorrhagia and bleeding disorders. Curr Opin Obst Gynaecol. 2007;19:513-20.

Santer M, Wyke S, Warner P. What aspects of periods are most bothersome for women reporting heavy menstrual bleeding? Community survey and qualitative study. BMC Women’s Health. 2007;1:7-8.

Shapley M, Jordan K, Croft PR. Why women consult with increased vaginal bleeding: a case control study. Br J Genet Pract. 2002;52:108-13.

Winkler UH. The effect of tranexaemic acid on the quality of life of women with heavy menstrual bleeding. Euro J Obstet Gynaecol Reprod Biol. 2001;99:238-43.

Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health related quality of life, work impairment and health care costs and its utilization in abnormal uterine bleeding. Value Health. 2007;10:183-94.

David Olive, Steven Palter. Reproductive physiology. In: Jonathan S. Berek, eds. Berek and Novak’s Gynaecology. 14th ed. Philadelphia: Lippincott Williams and Wilkins Company; 2002: 161-186.

Steiner RA, Fink D. Abnormal menstrual bleeding. Schweiz Rundsch Med Prax. 2002;91:1967-74.

Akande E, Hockaday T. Plasma luteinizing hormone levels in women with thyrotoxicosis. J Endocrinol. 1972;53:173.

Means JH. The thyroid and its diseases. In: Means JH, eds. A Book. 2nd ed. Philadelphia: J.B. Lippincott Co.; 1948: 571.

Wilansky DL, Greisman B. Early hypothyroidism in patients of menorrhagia. Am J Obstet Gynaecol. 1989;3:673-7.

Wg Cdr S. Sampath, Col P. Singh, Somani BL, Col MM. Arora, Lt Col HS. Batra, Lt Col AK. Harith, et al. Study of clinicobiochemical spectrum of hypothyroidism. Med J Armed Forces India. 2007;63(3):233-6.

Lewis Braverman, David Cooper. The thyroid. In: Lewis Braverman, David Cooper, eds. Ingbar and Werner’s Fundamental and Clinical Text. 10th ed. Philadelphia: Lippincott Williams and Wilkins Company. 2012: 792.

Doifode CD, Fernandes K. Study of thyroid dysfunction in patients with dysfunctional uterine bleeding. J Obstet Gynecol India. 2001;51:93-5.

Lakshmi Singh, Agarwal CG, Choudhary SR, Mehra P, Rajan Khare. Thyroid profile in infertile woman. J Obstet Gynecol India. 1990;40:248.