Abstract

Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. The prevalence of abnormal uterine bleeding is estimated to be in the range of 3% to 30%, with a higher incidence occurring around menarche and perimenopause. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find out the prevalence of thyroid disorders among perimenopausal women with AUB attending gynecology OPD.
Methods: In the present study, fifty patients with AUB were included and evaluated for the prevalence of thyroid abnormality. Thyroid function tests were done in all patients.
Results: Among 50 patients, 18 patients (36%) were diagnosed with hypothyroidism. The mean duration of Hypothyroidism was found to be 3.64 + 10.59. The mean T3, T4, TSH of the hypothyroid patients were found to be 2.4400 + 0.80, 10.25 + 0.86 and 8.76 + 1.67 respectively. Among 18 women with thyroid abnormality, menorrhagia was seen in 16(88.9%) women. 72.2% of the hypothyroid women did not have any associated complaints. 50% (n=9) of the hypothyroid women had a parity score of 2. 94.4% (n=17) had a healthy cervix on per speculum examination. 83.3% (n=15) had a bulky uterus on bimanual examination. 33.3% (n=6) had fibroids on USG and 33.3% (n=6) had adenomyosis. The mean endometrial thickness among the hypothyroid patients was found to be 10.11 + 4.64. Proliferative endometrium was found in 72.2% (n=13) and secretory endometrium was found in 27.8% (n=5) of hypothyroid women on histo-pathological examination. 66.7% (n=12) of the hypothyroid women were histo-pathologically diagnosed with AUB (L).
Conclusions: Thyroid dysfunction should be considered as an important associated factor for menstrual abnormalities even in perimenopausal women. It is important to screen all women for thyroid abnormality. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery