Thyroid function test in abnormal uterine bleeding

Abstract

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.

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

“…The most common pattern of AUB was found to be menorrhagia was most common 45 (47.37%) followed by metrorrhagia 20 (21.05%), polymenorrhoea 13 (13.68%), menometrorrhagia 8 (8.42%), hypomenorrhoea 6 (6.31%), and oligomenorrhoea 3 (3.15%). This is similar to study done by Kattel, et al 4 where menorrhagia (36.7%) was most common complaint among AUB. Bhavani, et al 12 found the incidence of menorrhagia to be 54%.…”

“…Oligomenorrhoea and hypomenorrhoea were associated with hyperthyroidism. This finding is similar to study done by Kattel, et al 4 Subedi, et al 11 and Byna, et al 17 TSH can be used as a screening test for every patient visiting gynaecology department with complaint of menstrual disorder. This will provide less financial burden to the patients rather than opting for whole thyroid function test.…”

“…Hypothyroidism is generally known to cause heavy and irregular menstrual bleeding and hyperthyroidism is generally associated with hypo, oligo and amenorrhoea. 1 Our finding is similar to studies done in Nepal and India where researchers also found majority of AUB cases associated with euthyroidism followed by hypothyroidism, Subedi, et al 10 found 89.3% cases were euthyroid and 9.3% hypothyroid; Thakur, et al 11 found 84.9% as euthyroid and 13.9% hypothyroid; Kattel, et al 4 found 80% cases euthyroid and 11.1% as subclinical hypothyroid; Bhavani, et al 12 found 81% cases as euthyroid and 10% as subclinical hypothyroid; Gowri M, et al 13 found 77.6% cases as euthyroid and 17.6% cases as hypothyroid. In contrast according to Ajmani, et al 14 44% of the patients with menstrual disorder had thyroid disorders.…”

“…1,2 Abnormal uterine bleeding (AUB) is known to affect 10-15% women of reproductive age globally, with prevalence of 6.2% in Nepal. 3,4 Hypothyroidism has been found to cause menorrhagia and hyperthyroidism to cause oligomenorrhoea and amenorrhoea. 1 Most cases of anovulatory bleeding can be treated by hormonal and non-hormonal medicines, thus avoiding surgeries.…”

Thyroid Dysfunction in Patients with Abnormal Uterine Bleeding in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…The most common type of abnormal uterine bleeding in this study was also menorrhagia followed by polymenorrhoea. In the study carried out by Kattel et al 23 thyroid dysfunction was present in 20% of abnormal uterine bleeding cases out of which 19% had hypothyroidism and 1% had hyperthyroidism. The most common type of abnormal uterine bleeding in this study was menorrhagia followed by metrorrhagia.…”