DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170580

A study of prevalence of thyroid disorders in patients with abnormal uterine bleeding

Ashok Kumar H. S., Saravanan S., Saravanan S.

Abstract


Background: Thyroid gland is the most vital endocrine organ which plays a major role in growth, development, metabolism and function of almost every organ of our body. Both hypothyroidism and hyperthyroidism can result in menstrual irregularities. Abnormal Uterine Bleeding (AUB) is one of the most common, yet complicated clinical presentation. It occurs in 10-20% of women between 15-50 years of age. Timely detection of thyroid dysfunction in patients presenting with AUB and their proper management can prevent unnecessary surgical interventions. This study was done to analyze the prevalence of thyroid dysfunction in patients with AUB and also to look for different menstrual patterns associated with thyroid dysfunction.

Methods: This is a prospective study conducted at Department of Obstetrics and Gynecology, Government Medical College, Manjeri, Kerala, India. Total 200 patients were recruited into present study after satisfying all inclusion and exclusion criteria. Complete history was taken followed by a thorough examination. Baseline investigations and T3, T4, TSH was performed in all patients. Results were analyzed.

Results: As per present study, majority of the patients with AUB were from the age group of 35-49 years (43%). In patients with AUB with thyroid dysfunction, prevalence of subclinical hypothyroidism was most common followed by hypothyroidism. According to our study thyroid dysfunction was most commonly seen in the age group of 35-49 years, and the most common presentation being menorrhagia.

Conclusions: Timely diagnosis and proper management of thyroid dysfunction in women with AUB can avoid variety of non-specific and ineffective diagnostic and therapeutic procedures.


Keywords


AUB, Hyperthyroidism, Hypothyroidism, Menstrual disorders, Subclinical hypothyroidism, Thyroid dysfunction

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References


Olive D, Palter S. Reproductive physiology. In: Berek JS, eds. Berek and Novak’s Gynaecology. 14th ed. Philadelphia: Lippincott Williams and Wilkins Company; 2002:161-86.

Ron E, and Brenner A, Non-Malignant Thyroid Diseases Following a Wide Range of Radiation Exposures. NIH Public Access. 2010;174(6):877-8.

Thomas R, Reid RL. Thyroid diseases and reproductive dysfunction. Obstet Gynaecol. 1987;70:789-98.

Mazzaferri EL. Evaluation and management of common thyroid disorders in women. Am J Obstet Gynaecol. 1997;176(3):144-9.

Kochupillai N. Clinical endocrinology in India. Curr Sci. 2000;79:1061-7.

Hollowell JG, Staehling NW, Flanders WD. Serum TSH, T4 and thyroid antibodies in the United States population (1988 to 1994): National health and nutrition examination survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-99.

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

ACOG practice bulletin: management of anovulatory bleeding. Int J Gynaecol Obstet. 2001;72:263-71.

Nesse R. Abnormal vaginal bleeding in peri-menopausal women. Am Family Physician. 1989;40:185.

Speroff L. Glass RH, Kass NG. In:Clinical gynaecologic Endocrinology and infertility. 6th ed. Baltimore: Lippincott Williams and Wilkins. 1999; 201-238,575-9.

M.G. Munro. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding innongravid women of reproductive age. Int J Gynecol Obstet. 113(2011):3-13.

Doifode CD, Fernandes K. Study of thyroid dysfunction in patients with dysfunctional uterine bleeding. J obstet and gynecol of India. 2001;51(2):93-5.

Wilansky DL, Grisesman B. Early hypothyroidism in patients with menorrhagia. Am J Obstet Gynaecol. 1990;163(2):697.

Narula ER; Menstrual Irregularities. J Obstet Gynecol India. 1967;17:164.

Pahwa S, Gupta S, Kumar J. Thyroid dysfunction in dysfunctional uterine bleeding. J Adv Res Biol Sci. 2013;5(1):78-83.

Pilli GS, Sethi B, Dhaded AV, Mathur PR. Dysfunctional uterine bleeding. J Obstet Gynecol India. 2001;52(3):87-9.

Padmaleela K, Thomas V, Lavanya KM, Kiranmai D. Thyroid disorders in dysfunctional uterine bleeding among reproductive age group women- a cross sectional study in a tertiary hospital in Andhra Pradesh, India. Int J Med Pharm Sci. 2013;04(01):41-6.

Braverman L, Cooper D. The thyroid. In: Braverman L, Cooper D. 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.

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