BACKGROUND AND OBJECTIVESDysfunctional uterine bleeding is an abnormal bleeding from the uterus in absence of organic disease of genital tract and demonstrable extragenital cause. Thyroid dysfunction is marked by large number of menstrual aberrations. This study aimed at detecting thyroid dysfunction and further evaluating in patients with a provisional diagnosis of DUB.

OBJECTIVE: To find the incidence of systemic causes of menorrhagia with special emphasis on careful history taking, clinical examination and inclusion of simple blood tests to diagnose hemostatic disorders. METHOD: Thirty two women with menorrhagia of 15-45 years age, without any pelvic cause and treated from 1st January, 2011 to 31st December, 2011 were recruited for this study. After a detailed history and general examination all patients were subjected to blood tests for complete blood count, bleeding time, prothrombin time, activated partial thromboplastin time (aPTT) and serum T3, T4, TSH levels. Special tests were reserved, wherever applicable, to diagnose the cause of menorrhagia. Results were analyzed statistically by 2 x 2 chi square test. RESULTS: Hypothyroidism (25%) and inherited coagulopathy (18%) were the two most common nonpelvic causes of menorrhagia. Menorrhagia from menarche (P<0.001), bleeding from other sites (P=0.007), history of previous operative bleeding (P<0.001), and history of postpartum bleeding (P<0.001) were statistically significant in patients with underlying hemostatic disorders. CONCLUSION(S):A detailed history, clinical examination and simple blood tests can detect systemic causes of menorrhagia.

Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out-patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing pathologists. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. We also tried to observe the incidence of various pathology in different age groups presenting with abnormal uterine bleeding. MATERIAL AND METHODS: This was a study done at Vijayanagara institute of medical sciences Bellary. 368 cases of isolated endometrial lesions diagnosed on histopathology were selected for the final analyses. A statistical analysis between age of presentation and specific endometrial causes was done using χ2 test. RESULTS: The most common age group presenting with AUB was 41-50 years (32.88%). The commonest pattern in these patients was normal cycling endometrium (35.53%). The commonest pathology irrespective of the age group was disordered proliferative pattern (20.65%). Other causes identified were complications of pregnancy (22.82%), benign endometrial polyp (11.41%), endometrial hyperplasias (5.97%), carcinomas (4.34%) and chronic endometritis (4.07%). Endometrial causes of AUB and age pattern was statistically significant with P value <0.05. CONCLUSION: There is an age specific association of endometrial lesions. In perimenopausal women AUB is most commonly dysfunctional in origin and in reproductive age group, one should first rule out complications of pregnancy. The incidence of disordered proliferative pattern was significantly high in this study, suggesting an early presentation of these patients.