THYROID DISORDERS IN DYSFUNCTIONAL UTERINE BLEEDING (DUB) AMONG REPRODUCTIVE AGE GROUP WOMEN - A CROSS- SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL IN ANDHRA PRADESH, INDIA

Introduction: Abnormal uterine bleeding is a common problem and its management can be complex. Thyroid hormones play a key role in the menstrual and reproductive function of women. It is recognized universally that menstrual disturbances may accompany clinical alterations in thyroid function. Both hypothyroidism and hyperthyroidism may result in menstrual disturbances. Since thyroid dysfunction is commonly prevalent in women, present study was conducted to assess the prevalence of thyroid disorders in dysfunctional uterine bleeding patients. Aims and objectives  To estimate the prevalence of thyroid disorders in women in reproductive age group with Dysfunctional Uterine Bleeding (DUB).  To evaluate thyroid function tests in women with DUB.  To assess the menstrual patterns in women with thyroid disorders. Material and methods Study design: Hospital based Cross sectional study. Study area: Dept. of Obstetrics and Gynecology, Government Victoria Hospital, Vishakapatnam. Study period: 1 year (Dec 2011 –Nov 2012) Materials: A predesigned and prestructured questionnaire, routine blood investigation, trans-abdominal USG, endometrial biopsy, serum T3, T4, TSH. Sample size: 83. Sampling: Systematic Random Sampling. Statistical Analysis: Analyzed using Epi-info version 3.5.2 Results: Most of the DUB cases were in the age group of 35 – 45 years, (53%) followed by 25-34 years (31.3%) and 15.7% were in the age group of 15 – 24 years. Thyroid disorders were prevalent in 26.5% of the women studied. Hypothyroidism was present in 18.1% and Hyperthyroidism in 8.4% of the women with DUB’s. Thyroid dysfunction was most common in women aged between 35 – 45 yrs i.e. (31.8%). The commonest menstrual complaint was menorrhagia which was present in 50% of the DUB cases. The most common finding in endometrial biopsy both in hypothyroid (60%) and hyperthyroid (57.1%) cases was proliferative type. Cystic Glandular Hyperplasia was found in 13.3% and secretory endometrium in 26.7% of hypothyroid patients. Conclusions: Thyroid dysfunction is associated with menstrual disturbances (abnormal uterine bleeding). Prevalence of hypothyroidism was more common than hyperthyroidism in DUB cases. Thyroid function tests should be performed in all patients with menstrual irregularities (DUB) to avoid unnecessary interventions.