Study of thyroid hormone profile in women presenting with abnormal uterine bleeding attending gynaecology out patient department, tertiary care centre Raipur

Menstrual disorders pose a huge burden on genecology OPD, accounting for 10-30% of attendance. Women with HMB have a significant impact on physical, emotional, social, professional and family perspectives which leads to decrease in work productivity. Thyroid gland is closely linked with the process of ovarian maturation and endometrial hyperplasia, its dysfunction also causes abnormal uterine bleeding (AUB).

This was an observational cross-sectional study performed at Pt J. N. M. medical college associated with Dr. B.R.A.M. hospital Raipur (C.G.) between 1st January 2020 to 31st December 2020. Total 100 cases between 18-45 years of age with AUB were included routine investigations and ultrasonography done.

Majority of AUB cases belong to the more than 39 years (46%), 41% were multiparous. The 20% cases of AUB have hypothyroidism, 2% have subclinical hypothyroidism, 7% have hyperthyroidism. Commonest pattern of bleeding was heavy menstrual bleeding (52%). They 37% cases had leiomyoma of uterus, 17% cases had adenomyosis, and 14% cases had ovulatory dysfunction. The 12 cases having hypothyroidism and 3 cases having hyperthyroidism presented with heavy and prolonged bleeding.

There is significant increase in thyroid disorders in cases with AUB as compared to general population. More than one fourth of cases of AUB were having thyroid disorder. Hypothyroidism is 3 times more common than hyperthyroidism. It is suggested that women of any age having AUB should be offered thyroid profile test to detect thyroid disorders. Early detection can provide early diagnosis and treatment. Metrics

Byna P, Siddula S, Kolli S, Shaik MV. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding. Int J Res Med Sci. 2015;3(11):3250-3. Dhanpal M, Sengodan SS, Subramanian V. prevalence of subclinical hypothyroidism in repkroductive age groups women with abnormal uterine bleeding. J. Evolution Med Dent Sci. 2016;5(30):1573-6. Nesse R. Abnormal vaginal bleeding in premenopausal women. Am Family Physian. 1984;40;185. Albers JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am Fam Phys. 2004;69(8):1915-34 Fraser IS, Critchley HO, Munro MG, Broder M. Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod. 2007;22(3):635-43. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive aged women. Obstet Gynecol. 2012;120:197-206. Munro MG, Critchley HOD, Fraser I. The FIGO system for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years who needs them. Am J Obstet Gynaecol. 2012;207(4):259-65. Das A, Chugh S. Dysfunctional uterine bleeding: a clinic-pathological study. J Obstet Gynecol India. 1964;14:343-7. Manjeera LM, Kaur P. Association of thyroid dysfunction with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2018;7:2388-92. Mahapatra M, Mishra P. Clinicopathological evaluation of abnormal uterine bleeding. J Health Res Rev. 2015;2:45-9. Verma R. A study on abnormal uterine bleeding in perimenopausal age in rural Bihar. J Med Sci Res. 2016;4:9262-74. Sangita A, Aggarwal D, Bhatia P, Sharma M, Sarabhai V, Paul M. Prevalence of overt and subclinical thyroid dysfunction among pregnant women and its effect on maternal and fetal outcome. J Obstetr Gynaecol India. 2014;64(2):105-110. Shapely M, Jordon K, Croft PR. An epidemiological survey of symptoms of menstrual loss in the community. Br J Gen Pract. 2004;54(502):359-63. Moghal N. Diagnostic value of endometrial curettage in abnormal uterine bleeding-a histopathological study. J Pak Med Assoc. 1997;47(12):295-9. Talukdar B, Mahela S. Abnormal uterine bleeding in perimenopausal women: correlation with sonographic findings and histopathological examination of hysterectomy specimen. J Mid-Life Health. 2016;7:73-7. Sharma N, Sharma A. Thyroid profile in menstrual disorders. JK Sci. 2012;14(1):14-7. Padmaleela K, Vimala T, Lavanya KM, Kiranmai D. Thyroid disorders and dysfunctional uterine bleeding (DUB) among reproductive age group women. A cross sectional study in a tertiary care hospital in Andhra Pradesh, India. Int J Med Pharm Sci. 2013;4(1):41-6. Gowri M, Radhika BH, Harshini V, Ramaiaha R. Role of thyroid function test in women with AUB. 2014;3(1):54-7.