Abstract
Introduction: Menstrual disturbances usually accompany clinical alteration in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from Thyroid disorder. A high serum Prolactin level can disturb the follicular maturation and corpus Luteum function, and lead to inhibition of normal pulsatile secretion of gonadotrophin releasing hormone in the hypothalamus resulting in anovulation.
Aim: To assess the Hyperprolactinemia and Thyroid disorder among patient with Abnormal Uterine Bleeding.
Method: A Hospital based cross-sectional, observational study was conducted in 150 patients in the department of gynaecology OPD in collaboration with department of Biochemistry and Endocrinology, IGIMS, Patna. The study lasts from May 2016 to October 2017. The patients who presented with abnormal uterine bleeding in age group of 15 -45 years in the out-patient department were recruited in the study after normal USG of Uterus and adnexa. Serum Prolactin and TSH, T3, T4 estimation and CBC, BT and CT were also done.
Result: In present study majority of patients were in the age group between 36-45 years and most of patient were multiparous (81.33%). Heavy menstrual bleeding (36%) was the most common symptom among AUB followed by Frequent menstruation (30%). Thyroid disorder (40.00%) and hyperprolactinemia (14.00%) was responsible for menstrual disturbances found in patient of AUB. Thyroid disorder and serum Prolactin both were responsible for AUB in (9.33%).
Conclusion: In our Study, 40.00% of cases had increased TSH, 14.00% had Increased Prolactin and 9.33% had both raised TSH and Prolactin associated with AUBand 36.67% were found to have no association with AUB.
Keyword: AUB, Prolactin, Thyroid function test.
References
- Fraser IS, Langham S, UhI- Hochgraeber K. Health related quality of life and economic burden of Abnormal uterine bleeding. Expert Rev Obstet Gynecol. 2009;4:179-89.
- Sharma A,Dogra Y. Trends of AUB in Tertiary centre of Shimla Hills. Jmid life Health. 2013;4:67-8.
- Morama B, Zarbo R, Puglisi F, Zarbo G. Dysfunctional uterine bleeding: medical the rapies [article in Italian].Minerva Ginecol 2003;55(3):241-251.
- 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 perimenopausal women. Am Family Physican. 1989;40:185.
- Eftekhari N, Mirzaei F, Karimi M. The prevalence of hyperprolactinemia and galactorrhoea in patient with abnormal uterine bleeding. Gynecol Endocrinol 2008; 24(50:289-291.
- Nawroth F. Hyperprolactinemia and the regular menstrual cycle in asymptomatic women: should it be treated during treatment for infertility? Repord Biomed online. 2005;11(50:581-8.
- Bragiota SI, Bonotis KS, Messinis IE, Angelpoulos NV. The effects of antisycotics on prolactin levels and the womens menstruation. Schizophr Res Treat. 2013:2013:502697.
- Doufas AG, Mastorakos G. The hypothalamic – pituitary -thyroid axis and the female reproductive system. Ann NY Acad Sci2000;900:65-76.
- Poppe K, Velkeniers B, Glinoer D. Thyroid disease and the female reproduction. Clin Endocrineol(Oxf) 2007;66(3);309-321.
- Mazzaferri EL. Evaluation and management of common thyroid disorders in women. Am J Obstet Gynaecol. 1997;176(3):144-9.
- National collaborating centre for womens and childrens health. Heavy menstrual bleeding. National Institute for health and excellance Clinical Guidline 44. London :RCOG Press; 2007. www. Nice. Org.uk/ guidance/ cg44. Accessed 29 july, 2015.
- Gopalakrishnan G, Buono D, Budner N, Howard AA, Floris-Moore M, Lo Y, etal. Impact of HIV on menstrual patterns and the bone mineral density. Poster presented at: 13th Conference on Retrovireses and opportunistic infection; February5-8,2006;Denver, CO, USA;2006.
- Moragianni VA, Somkuti SG. Profound hypothyroidism induce acute menorrhagia resulting in life threating anaemia. Obstet Gynecol 2007;110(2 Pt 2):515-517.
- John JD etal. Assessment of Thyroid and Prolactin level among the women with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2017 Jun;6(6):2547-2552.
- Pahwa S, Gupta S, Kumar J, Thyroid dysfunction in dysfunctional uterine bleeding. J Adv Res Bio 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.
- N Bhavani, Avanthi Sathinedi, Aradhana Giri, Sangeeta Chippa. Astudy of correlation between abnormal uterine bleeding and Thyroid dysfunction. Int J OF Recent Trends in science and Technology. ISSN227-2812.E-ISSN2249-8109, Vol 14 Issue.2015.
- Doifode CD, Fernandes K. Study of thyroid dysfunction in patients with dysfunctional uterine bleeding. JObstet Gynecol India. 2001;51:93-5.
- Sruthi T, Shivanna SB. Prevalence of hypothyroidism in patients with provisional diagnosis of DUB, J of Evolution of med and dental sciences 2014;3(1)2967-72.
- Shin SY, Lee YY, SY etal. Characteristics of menstruation- related problems for adolescents and premarital women in Korea. Eur J Obstet Gynecol Reprod Biol. 2005;121:236-42.
- Serr O, Chik CL, Ur E, Ezzat S. Diagnosis and management of HPL. Can Med J 2003;169-575-81.
Corresponding Author
Dr Dipali Prasad
Assistant Professor, Department of Obstetrics and Gynaecology
Indira Gandhi Institute of Medical Science, Patna