A study of association of thyroid disorders in patients with abnormal uterine bleeding
Journal Title: Medpulse International Journal of Gynaecology - Year 2019, Vol 9, Issue 3
Abstract
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. Thyroid disorders are 10 times more common in women than in men. Currently, subclinical thyroid dysfunction is on the rising side than overtdysfunction. The aim of the study: To determine the association between menstrual irregularities and thyroid dysfunction. To analyze the pattern of menstrual dysfunction among women with a thyroid disorder. Materials and Methods: The study comprised of 110 abnormal uterine bleeding cases admitted in the gynecology ward through OPD. Body mass index was calculated using height and weight. Systemic examination was carried out. Abdominal examination, speculum, and pelvic examination are done to rule out other causes of abnormal uterine bleeding. Investigations-complete blood count, platelet count, bleeding time, and clotting time, urine routine, blood sugar, RFT carried out. USG Pelvis is done. Histopathological examination ofendometrium performed by pipelle’s curette. Thyroid function test-Serum TSH, free T3, and free T4 are compulsory. 5ml of blood was taken in dry glass contains without any anticoagulant. Fasting sample was taken, TSH assay was performed using IRMA Kit (Immunoradiometric assay) Results: Among 110 patients,48 (48.5%) belongs to normal cohort and 7 (6.3%) belongs to thyroid dysfunction group in the age group 25-35 years. Out of 11 thyroid dysfunction, majority 7 (63.6%) were in the age group of 25-35 years. Menorrhagia presents in 39.4% of patients in normal cohort and 63.6% in thyroid dysfunction cohort. Hypomenorrhoea 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. Menorrhagia in 39.4% of patients in the normal cohort and 81.8% patients in thyroid dysfunction cohort. There exist adefinite significance between menorrhagia and thyroid dysfunction patients. Hypomenorrhoea presents in 4% of the normal cohort and 9.1% in thyroid dysfunction cohort. No statistical significance between hypomenorrhoea 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. Conclusion: The significant association between abnormal uterine bleeding and thyroid disorder (10%). It brings into focus the increased incidence of hypothyroidism among women with menorrhagia.It proves beyond doubt that TSH assay can be used in selective screening of women with abnormal uterine bleeding and in the prevalence of subclinical hypothyroidism (21.4%) as per AACE guidelines in this study. We are treating the only the tip of the disease but the submerging part of the disease also needs surveillance at frequent intervals to treat patients at the earliest and prevent morbidities in later life.
Authors and Affiliations
Sasikalai Kumari, Andal M
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