Background: DUB is defined as abnormal uterine bleeding without any clinically detectable pelvic pathology. The present study was conducted to compare the efficacy and safety of ormeloxifene and combined oral contraceptive pills in medical management of DUB. Methods: 110 cases of DUB aged between 25 and 45 years were randomly assigned into two groups. Group A received Ormeloxifene 60mg twice a week for 3 months and then once a week for next 3 months. Group B received combined oral contraceptive pills (Levonorgestrel 0.15mg and Ethinylestradiol 20mcg) one tablet from the 5 th day of menses for 21 days given for 6 cycles. Regular follow up was done to assess response, compliance and side effects of drug. The treatment was evaluated by measuring menstrual blood loss by PBAC (Pictoral Blood Loss Assessment Chart), Haemoglobin g/dl and endometrial thickness before and after treatment. Results: Ormeloxifene was found to be significantly more effective (P< 0.0001) than OC pills in controlling menorrhagia. There was significant decrease in endometrial thickness and improvement in Haemoglobin level in ormeloxifene group. Conclusion:Ormeloxifene is more effective and well tolerated than OC pills in treatment of DUB.

Polycystic ovary syndrome (PCOS) is the most common endocrinological problem and is the cause of irregular menstruation in the women of reproductive age. The present study was undertaken to find out novel inflammatory markers in polycystic ovary syndrome (PCOS). Study population was divided into two groups controls (n=100) and cases (n=100) diagnosed with PCOS were recruited for the study. The anthropometric data such as Height, Weight, BMI and, hormonal profile LH, FSH, LH/FSH ratio, Thyroid profile, Testosterone, HOMA-IR, Lipid profile, Monocytes, Neutrophils were noted for all the participants. Taking BMI 25 kg/m as the boundary, the control group was divided into Group A and Group B. Group A includes 53 subjects which is normal BMI group and Group B includes 47 subjects in the High-BMI group and among the cases Group C and Group D. Group C consists of 67 cases (normal BMI group) and 33 cases in the Group D (high BMI group). It is observed that monocyte HDL ratio (M/HDL ratio) and Neutrophil lymphocyte ratio (N/L ratio) in PCOS case group increased significantly (P&#60;0.05) when compared to control group. Through the analysis of differences between the subgroups along with LH, LH/FSH, Total Testosterone, M/HDL ratio, and N/L ratio can be considered as specific indicators of PCOS disease. Through correlation analysis, M/HDL ratio and N/L ratio showed association with hormone levels of LH and Total Testosterone respectively. Through ROC curve, it is found that M/HDL ratio is &#62;10.139 or N/L ratio is &#62;1.7 had diagnostic value for PCOS, and the combined diagnostic value of the two was higher. From the observation of this study, it can be concluded that M/HDL ratio and N/L ratio are not chronic inflammatory indicators caused by obesity but caused by the PCOS disease itself. Therefore, M/HDL ratio and N/L ratio can be used as diagnostic markers for PCOS.

Background: A relationship between the thyroid gland and the gonads is suggested by far more frequent occurrence of thyroid disorders in women than in men by clinical appearance of goiter during pregnancy, puberty, and menopause. Aim of this study was to determine the association between menstrual irregularities and thyroid dysfunction. To analyse the pattern of menstrual dysfunction among women with a thyroid disorder.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over 6 months in the year 2019. 100 women who presented with abnormal uterine bleeding with the below exclusion criteria. Detailed history taking with an emphasis on age, parity, infertility, and menstrual disorders. Evaluation by pelvic examination along with the general physical examination of those with menstrual complaints. Routine investigations like Hb, BT, CT, TLC, DLC, platelet count, and ABO-Rh in all. Then all patients were subjected to estimation of serum T3, T4, TSH with early morning samples.Results: Menorrhagia presents in 39.4% of patients in the normal cohort and 63.6% in the thyroid dysfunction cohort. Hypomenorrhea presents in 4% normal cohort and 9.1% thyroid dysfunction cohort. Hypothyroidism presents in 7.27%, subclinical hypothyroidism in 1.81%, and hyperthyroidism in 0.92% of patients. Amenorrhoea presents in 16.2% of patients of the normal cohort and 9.1% of patients of thyroid dysfunction cohort. No statistical significance between amenorrhoea and thyroid dysfunction.32.3% in the normal cohort and 36.4% in thyroid dysfunction cohort had a bulky uterus. No statistical association exists between thyroid dysfunction and uterine size. In a histopathological examination of the endometrium, 49.5% in the normal cohort and 54.5% thyroid dysfunction cohort reported as proliferative endometrium. Amenorrhoea; the significant association between abnormal uterine bleeding and thyroid disorder (10%).Conclusions: The significant association between abnormal uterine bleeding and thyroid disorder (10%). It brings into focus the increased incidence of hypothyroidism among women with menorrhagia.

Background: Menopause is a biological event characterized by the complexity of factors. On an average one-third of the women’s life consists of the post-menopause years, and health care programs for women do not address concerns beyond reproductive ages. The aim of this study was to describe the magnitude of menopause-related symptoms, the pattern of health care seeking, and associated factors. To assess the prevalence of gynecological disease in post-menopausal women.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over a period, months in the year 2019. Stages of reproductive aging workshop (STRAW) revised criteria and nomenclature are used for the ascertainment of menopause and inclusion of the women in the study. It provided a comprehensive basis for staging since there were more complexities on ascertainment of menopause explained. The STRAW criteria are considered as the gold standard for assessing menopausal stages.Results: A total of 600 participants were included in the study. The proportion of women who had at least one menopause-related symptom was 95.95 (95% CI 93.73-97.54) and 58.3% of women had severe symptoms. Severities of symptoms in psychological, physical, vasomotor, and sexual domains were 56.7%, 70.5%, 49.3%, and 10.2% respectively. Premature menopause (p<0.016), induced nature of menopause (p<0.031), dyslipidemia (p<0.006) and other medical condition (p<0.003) were associated with severity of menopausal related symptoms.Conclusions: A high proportion of women are affected by menopause-related symptoms. Care seeking for all symptoms is not uniform, indicative of a lack of knowledge about the treatable nature of many of these symptoms. Sensitization of both women and the health care system may serve to address this issue of menopause-related symptoms and the possibility of treatment for these.