Title: Correlation between Thyroid Disorders and Dysfunctional Uterine Bleeding: A Prospective Study
Authors: Prema Prabhudev, Surabhi Soni
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.57
Abstract
Introduction: Dysfunctional uterine bleeding (DUB) is an abnormal bleeding in absence of clinical or ultrasonographic evidence of structural abnormalities, inflammation or pregnancy. DUB accounts for 10% of the gynaecology related complaints. Thyroid dysfunction is one of the common causes of excessive menstrual blood loss and menstrual irregularities. Both hypothyroidism and hyperthyroidism are associated with a variety of changes in reproductive function including delayed onset of puberty, and anovulatory cycles and abnormal high fetal wastage
Aims and Objectives: To estimate serum fT3, fT4, TSH levels in women with DUB and to determine the frequency of thyroid dysfunction in women with dysfunctional uterine bleeding.
Material and Method: After approval from the institutional ethical committee and a written informed consent from the patients during the study period of 1 year in patients fulfilling inclusion criteria,100 women (with a minimum of 30 in each group) in child bearing age group (20-40 years) were selected. Their serum fT3, fT4 and TSH values were done at the time of presentation and treatment was given as per condition (hypothyroid or hyperthyroid). Then follow up was done after 3 months and 6 months interval and results were analysed using appropriate statistical methods.
Result: Among 100 subjects with menstrual complaints, 62% subjects were euthyroid & 38% subjects were hypothyroid. The incidence of menorrhagia (40%) followed by polymenorrhagia (30%) and metrorrhagia (30%) each. 60% of the subjects with polymenorrhoea had TSH level more than 4.25 uIU/ml whereas in menorrhagia and metrorrhagia 33.3% subjects had hypothyroidism. In menorrhagia improvement was seen in 80% subjects on administration of tablet Eltroxin.
Conclusion: As menstrual disturbances may accompany alterations in thyroid function so screening for thyroid dysfunction should be made an integral part of investigations and treatment of DUB as thyroid hormone plays an important role in menstrual and reproductive function of women.
Keywords: DUB, Thyroid, Menorrhagia, menstrual irregularities.
References
- Wilson, Beecham, Carrington. Obstetric and Gynaecology, 5thpp.80.
- Lakshmi Singh, CG Agarwal, SR Chowdhary, P. Mehra, RajanaKhare. Thyroid profile in infertile women. J. Of Obst. And Gyn of India 1990; 40: 248.
- Sampath S, Singh P, Somani BL, Arora MM, Batra HS, Harith AK, et al. Study of clinicobiochemical spectrum of hypothyroidism MJAFI 2007; 63(3):233-6.
- Pahwa Kaur. Ga. Thyroid Dysfunction in Dysfunctional Uterine Bleeding. JARBS.2013;5(1):78-83.
- Edson TR, et al. Low platelet adhesiveness and other haemostatic abnormalities in hypothyroidism. Am Int Med 1975;82:324.
- Lacour DE, Long DN, Perlman SE, Dysfunctional Uterine Bleeding in Adolescent Females associated with endocrine and medical conditions. J. Pediatrics and Gynecology, 2010;23(2) 234-7.
- JV Joshi, SD Bhandarkar, M. Chandha et al., : Menstrual irregularities and location failure may precede thyroid dysfunction or goitre, Institute of research in reproduction, Seth GS Medical College, Parel, Mumbai, Maharashtra, Volume 39; Issue 3;1993:137-4.