Title: Thyroid Status in Patients with Menstrual Abnormalities: A Prospective Study
Author: Dr Chetana A Gopchade
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.191
Abstract
Introduction: Menstrual abnormalities are one of the common causes of consultations in obstetrics and gynecology outpatient department. Abnormalities of thyroid function has been found to be associated with various menstrual abnormalities including amenorrhea, oligomenorrhoea, hypomenorrhea, menorrhagia, polymenorrhagia and metrorrhagia. for proper treatment of these patients it is important to diagnose abnormalities of thyroid function in these patients and since even subclinical hypothyroidism may cause menstrual abnormalities it is essential that every woman presenting with menstrual abnormalities (with no other obvious cause of such an abnormality) must undergo thyroid function test and appropriately managed.
Materials and Methods: This was a prospective study consisting of 250 women in reproductive age group presenting with menstrual abnormalities. They were included in this study on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and a thorough clinical examination was done in all the cases. Clinical examination including general and systemic examination was done in all the cases. Routine blood investigations such as complete blood count, bleeding time, clotting time, prothrombin time and ESR was done in all the cases. Ultrasound of abdomen and pelvis was done in all the cases. Pap smear, radioimmunoassay for infections was done in selected cases in whom cervical pathology or pelvic inflammatory disease was suspected. Thyroid function tests (T3, T4 and TSH) were done in all the cases. Data was analyzed using SSPE 20.0 software.
Results: Out of 250 studied cases 78% patients were euthyroid while subclinical hypothyroidism and clinical hypothyroidism was seen in 22 (8.80%) and 20 (8%) patients respectively. Hyperthyroidism was found in 12 patients. hypothyroidism was most commonly seen in the age group of 31-35 years (3.60%) while subclinical hypothyroidism was more common in the age group of 26-30 years (3.20%).
The most common menstrual abnormality in the studied cases was found to be menorrhagia which was seen in 94 (37.60%) patients followed by Polymenorrhea (18%). Most common menstrual abnormality in euthyroid (25.60%), subclinical hypothyroid (6.40%), hypothyroid (4.00%) as well as hyperthyroid patients (1.60%) patients was found to be menorrhagia. Common associated other than menstrual irregularities were found to be fatigue and constipation.
Conclusion: Abnormalities of thyroid functions are common in women with menstrual abnormalities. All patients presenting with menstrual abnormalities must undergo thyroid function tests if no other obvious cause of menstrual abnormalities is found.
Keywords: Menstrual abnormalities, Thyroid function tests, Subclinical Hypothyroidism, Fatigue.