scholarly journals A prospective study of thyroid dysfunction in dysfunctional uterine bleeding

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):  
Mangal Supe ◽  
Anup Arun Gundecha

Background: Dysfunctional uterine bleeding is dened as abnormal uterine bleeding not caused by any pelvic pathology, medications, pregnancy related complications or any systemic disease. It is the most common cause of abnormal uterine bleeding. It affects pubertal adolescents and perimenopausal women and is associated with considerable morbidity and affects patient’s family, personal and social life. Patient presents as menorrhagia, polymenorrhea, metrorrhagia or intermenstrual bleeding. It has great variations in endometrial patterns each deciding treatment modality. Objective: To determine frequency of various types of abnormal uterine bleeding and analyze the histopathology of endometrial curettage samples. Method: A prospective analytical study was conducted from Jan 2018 to Dec 2019 on sample of 650 patients between 20-70 years of age with symptoms of dysfunctional uterine bleeding presenting to medical college and hospital, Pimpri. Their endometrial samples were obtained by dilatation and curettage. To have a broader analysis the endometrial histopathology on hysterectomy specimens where the clinical diagnosis was DUB were also included in the study. Data obtained was tabulated and analyzed. Conclusion: The age group 31-40 and 41-50 years was the most common age group presenting with DUB. The predominant pattern of presentation was menorrhagia. The most common endometrial pattern on histopathology was proliferative type.


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.


2018 ◽  
Vol 12 (2) ◽  
pp. 74-78
Author(s):  
Pramod Kattel

Aims: To evaluate and detect the thyroid dysfunction in patients with abnormal uterine bleeding (AUB) from puberty to menopause.Methods: This is an observational descriptive study of 90 patients of abnormal uterine bleeding at Paropakar Maternity and Women’s Hospital, Kathmandu from 17th January 2016 to 16th January 2017. Besides thyroid function test Pap smear, endometrial biopsy and histo-pathological examination of uterus following hysterectomy was done in selected cases.Results: The incidence of AUB was 6.2 % with mean age of 37 years. The most common presenting complaint was menorrhagia (36.7%) followed by metrorrhagia (23.3%). Thyroid dysfunction accounted for 20% of AUB with major share occupied by subclinical hypothyroidism (11%) and least by hyperthyroidism (1%). The most common association of thyroid dysfunction with AUB was overt hypothyroidism (27.3%) with menorrhagia. Non-structural cases of AUB accounted for 30.4% of thyroid dysfunction.Conclusions: This study shows that thyroid dysfunction plays significant role for AUB so it is wise enough to perform TFT on routine basis in order to avoid unnecessary hormonal treatment with Estrogen, Progesterone or their combination and even the hysterectomies.


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):  
Runoo Ghosh ◽  
Rakesh R. Patel

Background: Abnormal uterine bleeding from the vagina that is usually occurred when ovary do not release egg and if it occurred during fertile period leads to various complication like anemia, Infertility etc. and among all causes one of the most common cause of abnormal uterine bleeding is disturbance in level of Thyroid hormones.Methods: 100 female Patients of age group between 20-45 having complain of Abnormal uterine bleeding visited at Gynec OPD of our institute were included in this study. fasting blood samples was taken from all participants and samples were analyzed for Thyroid function test (TSH, T3, T4) at central laboratory of our hospital. Obtained data was analyzed statistically by using prizam software.Results: The bleeding abnormality that is found most of the women is polymenorrhaggia and menorrhaggia. 32% of patients who were studied had thyroid dysfunction, of which 18% of patients had subclinical hypothyroidism, 11% of patients had hypothyroidism and only 3% of patients had hyperthyroidism.Conclusions: Present study concludes that thyroid dysfunction should be considered as an important etiological factor for menstrual abnormality especially during fertile period.


Author(s):  
Koduru Mounika

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases). The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %. Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made. Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.


Author(s):  
Ashok Kumar H. S. ◽  
Saravanan S. ◽  
Saravanan S.

Background: Thyroid gland is the most vital endocrine organ which plays a major role in growth, development, metabolism and function of almost every organ of our body. Both hypothyroidism and hyperthyroidism can result in menstrual irregularities. Abnormal Uterine Bleeding (AUB) is one of the most common, yet complicated clinical presentation. It occurs in 10-20% of women between 15-50 years of age. Timely detection of thyroid dysfunction in patients presenting with AUB and their proper management can prevent unnecessary surgical interventions. This study was done to analyze the prevalence of thyroid dysfunction in patients with AUB and also to look for different menstrual patterns associated with thyroid dysfunction.Methods: This is a prospective study conducted at Department of Obstetrics and Gynecology, Government Medical College, Manjeri, Kerala, India. Total 200 patients were recruited into present study after satisfying all inclusion and exclusion criteria. Complete history was taken followed by a thorough examination. Baseline investigations and T3, T4, TSH was performed in all patients. Results were analyzed.Results: As per present study, majority of the patients with AUB were from the age group of 35-49 years (43%). In patients with AUB with thyroid dysfunction, prevalence of subclinical hypothyroidism was most common followed by hypothyroidism. According to our study thyroid dysfunction was most commonly seen in the age group of 35-49 years, and the most common presentation being menorrhagia.Conclusions: Timely diagnosis and proper management of thyroid dysfunction in women with AUB can avoid variety of non-specific and ineffective diagnostic and therapeutic procedures.


Author(s):  
Santosh Kumar Verma ◽  
Anita Pal ◽  
Saroj Jaswal

Background: The objective of the study was to evaluate the prevalence of thyroid dysfunction in dysfunctional uterine bleeding and to assess the menstrual and endometrial pattern in women with thyroid disorders.Methods: The present study was conducted on 200 patients who presented with dysfunctional uterine bleeding in gynecology OPD.Results: Among the 200 women 39 (19.5%) had hypothyroidism, 2 (1%) had hyperthyroidism and 159 (79.55%) were euthyroid. Menorrhagia was the most common menstrual disorder in hypothyroidism and oligomenorrhoea in hyperthyroidism. In the present study 74.3% patients had proliferative endometrium,26.3% secretory endometrium, in hypothyroid patients and secretory endometrium in 2 (1%) hyperthyroid patients. A woman with hypothyroidism, commonly presents with anovulation and unopposed oestrogen activity causes endometrial hyperplasia which may outgrow the blood supply and may cause local areas of necrosis and breakdown and produces bleeding.Conclusions: The menstrual irregularities are significantly more frequent in patients with thyroid dysfunction and menorrhagia was the commonest menstrual abnormality. The study concludes that biochemical evaluation of thyroid function should be made mandatory in all cases of abnormal uterine bleeding and this would avoid unnecessary surgeries and exposure to hormones.


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.


Author(s):  
Girish A. Pote ◽  
Namita Nandkumar Raut

Background: Dysfunctional uterine bleeding (DUB) affects 10% to 15% women of reproductive age group. A prospective observational study was performed to study the efficacy, rate of satisfaction and adverse effects of Transcervical resection of endometrium (TCRE) in the treatment of DUB in premenopausal women.Methods: 30 patients with DUB attending the hospital underwent TCRE and patients were followed up after 6 week, 3 months, 6 months up to 1 year and there bleeding score was calculated. Their response to treatment, complications and satisfaction rate were studied.Results: 43.3% of the women in this study were in the age group of 40-44 years. Post TCRE, 43.33% (n=13) had hypomenorrhea. 33.33% (n=10) had regular cycle, 13.33% (n=4) women had amenorrhea and 10% (n=3) had no response and underwent hysterectomy. 86.66% (n=26) women were satisfied with the treatment whereas 13.33% (n=4) were not satisfied. One patient had uterine perforation and serosal bowel injury due to extended cautery injury. Bleeding reduced considerably and a statistically significant (paired t-test, p-value <0.05) difference was observed in pre and post procedure (6 weeks, 3 months, 6 months and 1 year) bleeding scores.Conclusions: Considering advantages like shorter operative time, uterine conservation and early mobility TCRE is a procedure of choice in patients in whom hysterectomy is either technically difficult or medically contraindicated or in those who are not suitable for long term medical management.


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