scholarly journals Abnormal uterine bleeding in relation to thyroid dysfunction

Author(s):  
H. C. Sudha ◽  
K. M. Sunanda ◽  
Anitha G. S.

Background: Abnormal uterine bleeding is an abnormal bleeding from the uterus in absence of any organic disease of genital tract and demonstrable extra genital causes. Thyroid dysfunction is marked by large number of menstrual abnormalities. This study is aimed at detecting thyroid dysfunction in patients with provisional diagnosis of AUB (abnormal uterine bleeding).and refer positive cases to physician for further management.Methods: All patients from are from puberty to pre-menopausal age groups, presenting as menoraghia, metrorragia, polymenorrhoea, polymenorragia, hypomenorrhoea, and acyclical bleeding. Onset, duration, amount of bleeding, complaints related to thyroid dysfunction was noted in detail. A thorough clinical examination including general physical examination, neck examination, systemic and gynecological examination was carried out, with special reference to thyroid dysfunction. A provisional clinical diagnosis of DUB was made. Patients with clinical signs and symptoms of thyroid disease were excluded. All these patients were subjected to routine investigations like Hb%, blood counts, urine routine, and bleeding and clotting time to rule out coagulation defects. Then all were subjected for serum T3, T4, and TSH estimation. Patients were then grouped into 4 categories: euthyroid, subclinical lhypothyroid, hypothyroid, and hyperthyroid. Patients who had thyroid disease, on hormonal treatment, IUCD users, and bleeding disorders were excluded.Results: Among 100 patients studied with abnormal uterine bleeding, patients were distributed according to age groups from puberty to perimenopause age. Majority of patients belongs to 31-40 years of age about 40% and the least age group were between 41-45 years of age.(7%).Among different parity status AUB was more common among para three patients(26%). Out of 100 patients, 32% of patients had thyroid dysfunction of which 16% of patients had subclinical hypothyroidism. 15% of patients had hypothyroidism and only 2% of patients had hyperthyroidism. The commonest bleeding abnormality in AUB were polymenorrhoea (30%) and menorrhagia (35%). All hyperthyroid cases were oligomenorrhoeic.Conclusions: This study concludes that thyroid dysfunction should be considered as an important etiological factor for menstrual abnormality. The biochemical evaluation of T3, T4, and TSH estimations should be made mandatory in AUB cases to detect apparent and occult thyroid dysfunction.

Author(s):  
Chaithra M. ◽  
Anitha G. S. ◽  
Savitha C.

Background: Dysfunctional uterine bleeding is abnormal uterine bleeding in the absence of any palpable pelvic pathology and demonstrable extra genital causes. Thyroid dysfunction is the systemic disease most often associated with abnormal uterine bleeding. Aim was to evaluate thyroid function test in women with DUB; to assess bleeding pattern in thyroid dysfunction.Methods: Prospective observational study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from august 2018 to July 2019. Pre structured and predesigned proforma filled. All routine blood investigations including serum T3, T4, TSH, USG were advised. These patients were categorized as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid based on thyroid profile.Results: 0.5% belonged to the age group of 31-40 years, prevalence of subclinical hypothyroidism is 11%, there were 5.5% of cases of hypothyroidism and 1.5% case of hyperthyroidism.Conclusions: Thyroid screening must be done mandatory for all the cases of DUB and prompt response to treatment with thyroxine would avoid unnecessary surgeries, hormonal treatment, and associated comorbities.


2021 ◽  
pp. 1-2
Author(s):  
MD Nurejjaman ◽  
Anuradha Ghosh ◽  
Shermin Siria Begum ◽  
Debarshi Jana

Introduction: The aim of the study was to determine the association between menstrual disturbances and thyroid dysfunction, to analyze the pattern of menstrual dysfunctions among women with thyroid disorder and to estimate the prevalence of subclinical thyroid diseases among women in the reproductive age group with abnormal uterine bleeding, Materials And Methods: This was an observational study conducted in the department of Obstetrics and Gynaecology, Institute of Post Graduate Medical Education & Research, SSKM Hospital, Kolkata from March 2019 to August 2020. Inclusion criteria were patients attending OPD with age group of 18-45 years, women with any of the following menstrual disturbances- menorrhagia, oligomenorrhoea, hypomenorrhea, polymenorrhoea, amenorrhoea with no pelvic pathology and USG showing normal uterus and ovaries. Conclusion: From our study, it may be concluded that there is a strong correlation of thyroid dysfunction with abnormal uterine bleeding. In the patients with abnormal uterine bleeding, if thyroid disorders are timely diagnosed and treated, the menstrual irregularities settle, and unnecessary intervention like hormonal treatment and surgery like hysterectomy can be avoided. Since thyroid dysfunction is an important treatable cause of abnormal uterine bleeding, estimation of thyroid status should be a part of the battery of investigations being done in the patients of abnormal uterine bleeding.


1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16


Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 


2021 ◽  
pp. 15-16
Author(s):  
Kumari Ragini ◽  
Kumar Sourav ◽  
Lata Shukla Diwedi ◽  
Debarshi Jana

Introduction: Abnormal uterine bleeding (AUB) is a common disorder occurring in reproductive age group females. It can be understood as bleeding that occurs from the uterus outside the normal parameters and there is no structural defects in the genital tract. One of the most common association with AUB is thyroid dysfunctions. Hence this study aimed to see the incidence of thyroid related disorders in AUB and also to assess the menstrual pattern. Material and Methods: 100 women suffering from AUB who presented to OPD of Obstetrics and Gynecology department of Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar were recruited in the study. All females in 19 to 45 years of age group with abnormal uterine bleeding were included excluding those with previously known thyroid disorder, abortion history within 3 months etc. Thyroid function tests were done in all along with ultrasonography of pelvis region. Statistical analysis done. Results: The bleeding abnormality that was found in the most of the women was heavy menstrual bleeding. Women who presented with thyroid dysfunction were 33%. 23% had subclinical hypothyroidism, 6% had hypothyroidism and 4% had hyperthyroidism. Conclusion: Abnormal Uterine Bleeding has strong association with thyroid disorders. Most common type of disorder is subclinical hypothyroidism. Thus all patient of AUB must be evaluated for thyroid dysfunction


2016 ◽  
Vol 6 (12) ◽  
pp. 1018-1020
Author(s):  
S Subedi ◽  
B Banerjee ◽  
C Manisha

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.


Author(s):  
Hema K. R. ◽  
Girish B. L. ◽  
Dhananjaya B. S. ◽  
Riyaj Ahmad Kalaburgi

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.


2017 ◽  
Vol 7 (2) ◽  
pp. 29-41
Author(s):  
Mukund Tiwari ◽  
Dr. Sarita Agrawal ◽  
Subarna Mitra

Abnormal function of thyroid gland is associated with a disturbance in the menstrual cycle. However, in clinical practice, thyroid dysfunction is frequently overlooked as a possible etiology and therefore, the importance to investigate thyroid function in asymptomatic cases is under- recognized in India. Treating thyroid dysfunction in such cases can reverse the menstrual abnormality, thus avoiding unnecessary hormonal therapy or in long term, hysterectomy. This article is intended to determine the prevalence of overt and subclinical forms of hypothyroidism/hyperthyroidism among women with abnormal uterine bleeding (AUB) in a known iodine-deficient state of India, Chhattisgarh. Moreover, the aims included to characterize the types of menstrual abnormality with thyroid dysfunction in study participants. The present study found a prevalence of thyroid dysfunction in one out of five cases of menstrual abnormality, most common dysfunction being hypothyroidism. An appreciable proportion of thyroid disorder was found in patients with menorrhagia, oligomenorrhea, polymenorrhea and amenorrhea.


Author(s):  
Dinesh Gurjar ◽  
Purnima Pachori ◽  
Sandhya Chaudhary ◽  
Dharmendra Singh

Background: Hypothyroidism and Hyperthyroidism leads to menstrual irregularities. Females with thyroid gland abnormality have chances of reproductive abnormalities ranging from abnormal sexual development, menstrual irregularities, infertility and premature menopause. The objectives were to study the association between thyroid dysfunction and AUB in the reproductive age group (18-45 years), To study the thyroid abnormalities in different types of AUB in the reproductive age group, to establish if screening for thyroid abnormalities is justified using T3, T4 and TSH.Methods: This cross-sectional study conducted among 250 women with ‘abnormal uterine bleeding’ (AUB). Inclusion criteria for participants were females in the age group of 18-45 years, females presenting with abnormal uterine bleeding, with thyroid dysfunction, females who do not have signs of demonstrable pelvic pathologyincluding PID.Results: Majority of the patients belonged to the age group of 24 - 32 years i.e.56.8%, 9.2% cases were nullipara, 44.0% cases have menorrhagia, 32.2% have oliogomennorrhea, 19.6% have amenorrhea. Around 3.6% had Thyromegaly, 12.4% have weight gain in hypothyroidism, 28.4% have fatigue in hyperthyroidism, 6.8% cases have higher T4 level, 18.0% cases have higher TSH level.Conclusions: The risk of progression to overt hypothyroidism (about 5% per year) in patients with subclinical disease and the cost-benefit ratio also emphasises the need for selective screening. Early detection of subclinical disease by selective screening facilitates appropriate therapy early in the course of the disease.


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