scholarly journals Thyroid disorders in women with dysfunctional uterine bleeding

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):  
Rini Ezhil ◽  
Nivedita K. ◽  
Fatima Shanthini N.

Background: The most common complaint with which women present for gynecological consultation is abnormal uterine bleeding which may be due to varied etiology. Among non-structural causes for AUB, endocrinological disorders like thyroid dysfunction is very common. Thyroid dysfunction is often overlooked, and unnecessary hormonal or surgical interventions are performed in patients with AUB.Methods: This is a hospital based cross sectional study carried out in Sri Manakula Vinayagar Medical College and Hospital, Puducherry between January 2017 to June 2017 for a period of 6 months and the participants were 200 women attending gynecological OPD with complaints of abnormal uterine bleeding. After obtaining a written informed consent from the participants a detailed history and complete examination including a thorough gynecological examination was performed. A transvaginal ultrasound examination to note for any structural causes for AUB was performed. Thyroid function test (FT3, FT4, TSH) was performed in all study participants and they were then categorized into euthyroid, hypothyroid, hyperthyroid, subclinical hypo or hyperthyroid based on the results. After preliminary preparation all participants were subjected for an endometrial biopsy in the outpatient department and the tissue obtained was sent for histopathological analysis. All the information was tabulated and analyzed using SPSS 22 version with descriptive and inferential statistics (chi square test). A p value of < 0.05 was considered as statistically significant.Results: Heavy menstrual bleeding was the most common menstrual abnormality found in 85% of the study participants.77% had structural causes for AUB whereas 23% had non-structural causes. 79.5% of the patients with AUB were euthyroid whereas 20.5% had some form of thyroid dysfunction. Subclinical hypothyroidism was the most common thyroid dysfunction (15.5%) in this study followed by hypothyroidism (3.5%). Only 1.5% of patients had hyperthyroidism. In the present study no, significant association was found between any particular thyroid dysfunction and specific menstrual pattern or endometrial pattern in histopathology.Conclusions: Testing and treating for thyroid disorder would prove to be cost effective in patients with AUB particularly with nonstructural causes as it would avoid many costly interventions done for AUB.


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):  
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.


Author(s):  
Usharani N. ◽  
Kaveri Shavi

Background: Dysfunctional uterine bleeding is one of the most frequently encountered condition in gynaecological practice. Thyroid hormones play a key role in the menstrual and reproductive function of women and thus thyroid dysfunction results in menstrual disturbances. The objective is to study the prevalence of thyroid disorders in patients with dysfunctional uterine bleeding.Methods: This is a hospital based prospective observational study done in the department of Obstetrics and Gynaecology, Vijayanagara Institute of Medical Sciences, Ballari. The study period is from February 2016 to August 2016. In the study, 100 patients with dysfunctional uterine bleeding were included and evaluated for thyroid abnormality.Results: Among 100 patients with DUB, thyroid disorders were prevalent in 24 % of patients. Hypothyroidism was present in 22% and hyperthyroidism in 2% of the women with DUB. The commonest menstrual complaint associated with hypothyroidism was menorrhagia, seen in 54.54% of cases. In 2 patients with hyperthyroidism one each had menorrhagia and metropathia haemorrhagica.Conclusions: Thyroid dysfunction is one of the important cause for DUB. Hypothyroidism is more commonly associated with DUB than hyperthyroidism. Evaluation of thyroid status is important in all patients with DUB to avoid unnecessary surgical interventions.


Author(s):  
Jovita Deepthy John ◽  
Vimala Damodaran ◽  
Shankar Radhakrishnan

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.


2020 ◽  
Author(s):  
Khalid Alshehri ◽  
Raghad Al Thobaiti ◽  
Athar Alqurashi ◽  
Nada Algethami ◽  
Khaled Alswat

Abstract Background: Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score.Methods: A cross-sectional study for female patients who had a routine clinic visit were included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥ 19 or scored ≥ 5 on any item or ≥ 4 on three items were considered to have FSD.Results: A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master’s degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). Conclusion: One-third (32.5%) of the study participants had a FSD. Those with type 1 diabetes had the highest ASEX scores. We detected non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.


Author(s):  
G Sindhujha Sekar ◽  
A Esther Ruby ◽  
P Lalitha

Introduction: In perimenopausal age group particularly, 70% of all gynaecological consultations are for Abnormal Uterine Bleeding (AUB). About 30% of women seek medical assistance for AUB during their reproductive age group and about one third of hysterectomies are carried out for AUB alone. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of Transvaginal Ultrasonography (TVS) versus hysteroscopy in detecting uterine abnormalities Materials and Methods: A cross-sectional study in patients with AUB, admitted to the Department of Obstetrics and Gynaecology at RGGWCH, Puducherry between February 2016 and February 2017 who met the inclusion criteria were included. Sample size was 85 cases. After taking detailed history and physical examination the patient was investigated to rule out organic causes of AUB and then TVS and hysteroscopy were done. Any intrauterine pathology was looked for and endometrial sampling was taken from the abnormal sites for Histopathological Examination (HPE). Both TVS and hysteroscopy results were compared with histopathology which is the gold standard. Results: The sensitivity of TVS in diagnosis of uterine fibroid in comparison to hysteroscopy was 94.74% and the specificity was 71.21%. The sensitivity of hysteroscopy in diagnosis of endometrial hyperplasia in comparison to HPE was 75% and the specificity was 87.01%. The sensitivity of TVS in diagnosis of endometrial hyperplasia in comparison to HPE was 37.5% and the specificity was 90.91%. The sensitivity of hysteroscopy in diagnosis of polyp in comparison to HPE was 100% and the specificity was 97.3%. The sensitivity and specificity of TVS in diagnosis of polyp in comparison to HPE were 9.09% and 93.24%, respectively. Conclusion: TVS had a high sensitivity to detect fibroids but its value in detecting hyperplasia and polyps was in question in this study. But hysteroscopy had a maximum sensitivity to detect polyps and high sensitivity to detect endometrial hyperplasia compared to histopathology which is a gold standard investigation.


Author(s):  
Fatemeh Moradi ◽  
Fatemeh Alizadeh ◽  
Nafiseh Zafarghandi ◽  
Farhad Jafari ◽  
Mahdi Alizadeh Vaghasloo ◽  
...  

Abnormal Uterine Bleeding (AUB) is the most common reason for women’s medical referral in the reproductive age. In Persian Medicine, one of the major causes of this disorder is known as uterine dystemperament (Su-e-Mizaj). AUB is known as “Kesrat-e Tams” in this medical school. We aimed to investigate the frequency of positive symptoms of uterine dystemperament in patients with AUB from the perspective of Persian Medicine. This cross-sectional study was conducted from October 2009 to September 2010 in Tehran, Iran. It comprised 70 patients with abnormal uterine bleeding who were 15-45 years old. Data were collected by a questionnaire prepared based on the textbooks of Persian Medicine. The frequency of each symptom of uterine dystemperament was obtained. Among the four uterine dystemperaments, the “dry” and “warm” uterine types had the highest rankings. In patients with excess uterine hemorrhage, the symptoms of warm uterine is more frequent than cold uterine. Meanwhile, the warm uterine dystemperament interference was also observed in excess uterine hemorrhage.


Author(s):  
Aditi Rai ◽  
Sapna Raina

Background: Abnormal uterine bleeding (AUB) is one of the most frequent presentation to gynecology OPD. 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. Thyroid disorders are more common in women than in men and cause abnormal sexual development, menstrual irregularity, infertility and premature menopause. Objective of this study was to estimate the prevalence of thyroid disorders in women in reproductive age group with AUB.Methods: A hospital based prospective cross sectional observational study was carried out in department of obstetrics and gynecology, Mazumdar-Shaw Cancer and Medical Center and Narayana Hrudayalaya Hospital at Narayana Health City, Bangalore with abnormal uterine bleeding during the period of 2 years (December 2015 to November 2017), total 153 patients were included in the study. All women with AUB in reproductive age group were included. Diagnosed cases of ovarian cyst, uterine fibroid, polyp, adenomyosis, endometriosis and malignant (endometrial and cervical) tumors were excluded. Women who are on drugs or hormone therapy (for past 3 months. IUCD users/oral contraceptives pill user. Patients with known case of thyroid disorder, carcinoma thyroid patients with history of coagulation disorder, liver disorder, renal disorder, tuberculosis.Results: A total N=115 (75.2%) of patients who took part in this study had euthyroid status. The estimated prevalence of thyroid dysfunction was 24.9%. Out of which n=22 (14.4%) had subclinical hypothyroidism, n=14 (9.2%) had overt hypothyroidism, n=2 (1.3%) had hyperthyroidism. The most common thyroid dysfunction amongst the study group was noted to be subclinical hypothyroidism (14.4%).Conclusions: There is a high prevalence of thyroid disorders in cases which are clinically diagnosed as AUB. TSH is most sensitive test in detecting thyroid dysfunction. Subclinical cases need to be treated. Hence thyroid function evaluation should be made mandatory in cases of AUB to detect thyroid dysfunction.


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