A STUDY OF ASSOCIATION OF THYROID DISORDERS IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

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.

Prevalence of hypothyroidism in reproductive age group in rural population of Haryana and its effects on menstrual disturbances

Background: Menstrual disorders are a common problem in reproductive age females. These disorders may cause significant anxiety for patients and their families. Thyroid dysfunction is one of the common cause of menstrual irregularities. Aim of the study was to determine the prevalence of hypothyroidism in reproductive age group women (15-45years), describe its various modes of clinical presentation and to assess the menstrual pattern in women with hypothyroidism.Methods: Prospective observational hospital based study during a period of 6 months (January 2020 to June 2020) on patients presenting in OPD in department of obstetrics and gynaecology, SGT medical college, hospital and research institute, Budhera, Gurgaon.Results: Prevalence of hypothyroidism was found to be 52.6% (190 out of total 338 patients) and it increased with increasing age group. 213 patients out of total came with complains of menstrual irregularities. 49.2% with normal menstrual cycle had hypothyroidism while 60.4% presenting with irregular heavy menstrual bleeding had hypothyroidism, p value being 0.019 which was statistically significant.Conclusions: Menstrual irregularities increase with severity of hypothyroidism. So screening for thyroid dysfunction should be included in management plan of menstrual disturbances.

The affected factors of puberty and menstrual disturbances among female students at Al-Andalus university

<p><strong>Background:</strong> The aim of the study was to determine the pubertal, menarcheal age and menstrual disturbances, and the factors affecting them, during the war in Syria, among AL-Andalus university female students.</p><p><strong>Methods:</strong> A self-reported questionnaire was answered from 156 students. The questions were about socio-demographic information, reproductive and menstrual patterns, and the participants' lifestyle. Inclusion criteria included girls 17 to 25 years old, no systemic diseases and completed the questionnaire. The questionnaire was answered in the university. The researchers clarified the aim of the study and got the voluntary consent. The data of 148 girls were entered intoSPSS. Exclusion criteria excluded girls (≤17 and ≥25) years and those who did not complete the questionnaire. The study was conducted from 20 January 2020 to 20 March 2020.</p><p><strong>Results:</strong> 148 cases were analyzed. The mean age of puberty and menarche of our students are 12.38±1.41 and 13.38±1.35 years respectively. Fast food and changing adopted place have a significant association with menstrual disturbances (p&lt;0.05). Blood group, faculty, weight and the mother's menarcheal age have no effects on them (p&gt;0.05).</p><p><strong>Conclusions:</strong> Not found any change in the age of puberty and menarche, but this does not prevent to make more studies in different places in Syria in the future.</p>

Hormonal Contraceptive Use, Menstrual Dysfunctions, and Self-Reported Side Effects in Elite Athletes in Denmark

Objective: To identify the prevalence of hormonal contraceptive (HC) use, menstrual cycle disturbances, and self-perceived physical and emotional symptoms related to the menstrual cycle/pill cycle in elite female athletes. Methods: One hundred eighty-six Danish elite female athletes completed an online questionnaire to assess menstrual status and history, use of HCs, and self-perceived physical and emotional symptoms related to the menstrual cycle or HC use. Results: Fifty-seven percent of elite female athletes in Denmark use HC, with 74% using combined HCs and 26% using progestin only. Sixty percent of oral contraceptive users reported having manipulated their menstrual cycle by continuous oral contraceptive use. Forty-nine percent of non-HC users had a regular menstrual cycle, while 51% experienced menstrual disturbances, with 1 athlete being primary amenorrheic and 13 athletes having secondary amenorrhea. Menstrual disturbances were experienced by a larger proportion of endurance athletes (69%) compared with athletes performing power and technical disciplines. In endurance athletes amenorrhea was associated with a higher cardiovascular training volume (P < .001). Negative symptoms related to the menstrual/pill cycle were reported by both HC and non-HC users, whereas positive physical symptoms were experienced more often among the non-HC (14%) versus HC users (2%) (P < .01). Notably, 13% of the athletes reported that negative symptoms sometimes/always caused them to not participate in or complete the scheduled training. Conclusion: HC use is common among elite athletes, and continuation of HC is used to manipulate the menstrual cycle in relation to sport competitions. HC use does not abolish dysmenorrhea, but it may reduce emotional-related side effects. Menstrual disturbances are frequent in endurance athletes and are associated with cardiovascular training volume.

The Menstrual Disturbances in Endocrine Disorders: A Narrative Review

Context: Menstrual cycle is considered the fifth vital sign among women. This study aimed to summarize the menstrual disturbances in different endocrine disorders. Evidence Acquisition: In this narrative review, relevant studies (up to December 2019) were searched based on the MeSH keywords diabetes, polycystic ovary syndrome, Cushing’s syndrome, thyroid dysfunction, hyperprolactinemia, menstrual cycle, uterine bleeding, and menstruation. Databases used for searching articles included Google Scholar, Scopus, PubMed, and Web of science for observational, experimental, and review studies. Results: Endocrine disorders trigger the onset of menstrual disturbance across the reproductive lifespan of women. Endocrine glands (pituitary, thyroid, pancreas, adrenal, and ovaries) have a functional role in endocrine regulation of the menstrual cycle. According to available evidence, oligomenorrhea (cycles longer than 35 days) is the most common menstrual disturbance among endocrine disorders (thyrotoxicosis, hypothyroidism, polycystic ovary syndrome, Cushing’s syndrome, and diabetes). Complex endocrine pathways play an essential role in a women’s menstrual calendar. Conclusions: The menstrual cycle length and amount of bleeding can be indicative of endocrine disorders. Further studies are needed to identify the unknowns about the association between endocrine disorders and the menstrual cycle.

Clinical profile of 500 cases of Polycystic Ovary Syndrome in a Tertiary Hospital

Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to18% of women. It has been suggested that this condition occurs in as many as 4-10% ofwomen of reproductive age. PCOS is associated with significant reproductive morbidity,including infertility, abnormal uterine bleeding, miscarriage and other complications ofpregnancy. Method: This cross-sectional study was carried out in the Department of Obstetrics andGynaecology of Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January,2013 to December, 2016 over a period of 4 years with the objective to find out various clinicalpresentations, endocrine status, the menstrual abnormalities and sonographic findings ofthe patients with PCOS. During the study period a total number of 1600 patients wereexamined for infertility in the Outpatient and in Inpatient Department. Out of these 1600infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailedinformation about the patients were collected in a predesigned data collection sheet. Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%)had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration ofinfertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in78.0 percent of PCOS patients, of which & 90 (18.0%) had amenorrhoea, 250 (50.0%) hadoligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normalmenstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normalBMI and 60 (12.0%) were under weight. Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients.Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalenceof menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% hadamenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 45-48