Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

Prasanna Byna, Shireesha Siddula, Swathi Kolli, Mahaboob Vali Shaik
In: International Journal of Research in Medical Sciences · 2015 · pp. 3250–3253 · doi:10.18203/2320-6012.ijrms20151171 · W2268638731
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This study evaluated the correlation between thyroid dysfunction and abnormal uterine bleeding in 55 perimenopausal women attending a gynecology outpatient department. The researchers found that while 65.4% of participants were euthyroid, 20% presented with structural abnormalities including adenomyosis, fibroids, or ovarian cysts, and the remaining cases were linked to thyroid disorders such as hypothyroidism or hyperthyroidism. The authors concluded that screening for thyroid abnormalities is essential in these patients to avoid unnecessary hormonal treatments or surgery, noting that correcting thyroid issues can relieve bleeding symptoms. Relevance to endometriosis: adenomyosis is listed as one of the structural causes identified in this cohort of women with abnormal uterine bleeding.

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Abstract

Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients.Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4%) were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42%) women, 6 (31.57%) had polymenorrhagia, 5 (26.31%) had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women) was heavy menstrual bleeding in 5 (41.6%) women, 3 (25%) had oligomennorhoea, 4 (33.3%) had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57%) had oligomenorrhoea, 3 (42.8%) had heavy menstrual bleeding, 2 (28.57%) had polymenorrhagia. In a total of 55 patients with AUB, 11 (20%) had structural abnormalities in uterus and ovaries. 5 (9%) had adenomyosis, 3 (5.4%) had ovarian cysts, 3 (5.4%) had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery.
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Background

AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD.

Methods

In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients.

Results

Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4%) were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42%) women, 6 (31.57%) had polymenorrhagia, 5 (26.31%) had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women) was heavy menstrual bleeding in 5 (41.6%) women, 3 (25%) had oligomennorhoea, 4 (33.3%) had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57%) had oligomenorrhoea, 3 (42.8%) had heavy menstrual bleeding, 2 (28.57%) had polymenorrhagia. In a total of 55 patients with AUB, 11 (20%) had structural abnormalities in uterus and ovaries. 5 (9%) had adenomyosis, 3 (5.4%) had ovarian cysts, 3 (5.4%) had fibroids.

Conclusions

It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. Metrics

References

Devi J, Aziz N. Study of histopathological pattern of endometrium in abnormal uterine bleeding in the age group 40-60 years. A study of 500 cases. Int J Med Sci Clinic Invent. 2014;1:579-85. Padubidri VG, Daftary SN. AUB. In: Padubidri VG, Daftary SN, eds. Shaw’s Textbook of Gynecology. 16th ed. USA: Elsevier Health Sciences; 2015: 335-348. Sharma N, Sharma A. Thyroid profile in menstrual disorders. JK Sci. 2012;14(1):14-7. Gowri M, Radhika BH, Harshini V, Ramaiaha R. Role of thyroid function tests in women with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2014;3(1):54-7. Vinita S, Ashwini SN. Impact of thyroid disorders on menstrual function. Fogsi Focus. 2006;1:30-1. Pushpa S, BikhaRam D, Razia MA, ZulfiquarAli SS, Tarachand D, Ishrat B. Impaired thyroid functions in patients with menstrual disturbances (An experience of a private clinic). World Appl Sci J. 2009;7(4):538-42. Sruthi T, Shilpa SB, Gopal N. Prevalence of hypothyroidism in patients with provisional diagnosis of DUB. J Evol Med Dent Sci. 2014;3(11):2967-72. Bhavani N, Avanthi S, Aradhana G, Sangeeta C, Prasannakumar VS. A study of correlation between abnormal uterine bleeding and thyroid dysfunction. Int J Recent Trends in Sci Technol. 2015;14(1):131-5. Padmaleela K, Vimala T, Lavanya KM, Kiranmai D. Thyroid disordrs 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.

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