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TO OBSERVE THE THYROID PROFILE IN

DYSFUNCTIONAL UTERINE BLEEDING


PATIENTS PLANNED FOR
HYSTERECTOMY
ABSTRACT
Background
Menorrhagia is a frequent debilitating symptom in
gynecological practice resulting in need for repeated curettage
and hysterectomy with its attendant morbidity and mortality.
The etiology of menorrhagia is very diverse, it may be due to
systemic conditions like endocrine disorders (thyroid
dysfunction), or local lesions of the genital tract (endometrial
hyperplasia, pelvic inflammatory disease, endometriosis, benign
& malignant tumors). Thyroid dysfunction is one of the common
causes of menstrual irregularities.
AIMS AND OBJECTIVES
Present study was carried out to evaluate the thyroid function in
group of patients who were planned for hysterectomy due to
dysfunctional uterine bleeding.
METHODS
50 patients were selected from the Department of Obstetrics &
Gynecology who were planned for hysterectomy due to DUB.
On the basis of menstrual pattern, patients were divided into 4
groups, after excluding organic causes of uterine bleeding.
RESULTS
Mean serum T4 and TSH levels in group A (menorrhagia) were
7.52 + 2.12 µ g/dl (range 3.6-12.5 µ g/dl) and 3.7 + 4.77 µ
IU/ml (1.0-24 µ IU/ml), 1 had 1° hypothyroidism , group B
(menometrorrhagia) were 7.28 + 1.99 µ /dl & 2.97 + 3.41 µ
IU/ml (range 0.8-15.2 µ /ml). 1 had 1° hypothyroidism, All
patients in group C (polymenorrhea) and Group D
(Intermenstrual spotting) had normal serum T4 and TSH levels .
CONCLUSION
4% of the DUB patients were hypothyroid (TSH reference range
0.4 - 6.0 µIU/ml).
If followed recommendation by AACE, (TSH reference range-
0.3 -3.0 µIU/ml), 24% of our patients would be hypothyroid.
This study needs expansion in the form of sample size with
inclusion of control to establish a firm association between
thyroid dysfunction & DUB.

INTRODUCTION
Thyroid dysfunction is one of the common causes of
menstrual irregularities. Present study was carried
out to evaluate the thyroid function in group of
patients who were planned for hysterectomy due to
dysfunctional uterine bleeding.
AIMS AND OBJECTIVES
Evaluation of thyroid status (euthyroid, hypothyroid,
or hyperthyroid) in dysfunctional uterine bleeding
patients.
SAMPLE SELECTION
50 patients were selected from OPD/IPD in
Department of Obstetrics and Gynaecologywho
were plammed for hysterectomy due to
dysfunctional uterine bleeding.
METHODOLOGY
On the basis of clinica features, patients were
devided into 4 groups, after excluding organic
causes of uterine bleeding.
OBSERVATION
Our study included 50 cases of dysfunctional uterine
bleeding, divided into 4 groups on the basis of
clinical features.
(1) Group A (n=20) : Patients with menorrhagia.
(2) Group B (n=15): Patients with
menometrorrhagia.
(3) Group C (n=10): Patients with polymenorrhoea.
(4) Group D (n=5): Patients with intermenstrual
spotting.

COMPARISION OF THYROID FUNCTION


AMONG GROUP A, B, C AND D.

Group S. T4 S.TSH
(µg/dl) (µIU/ml)
A Mean + 72.52 + 3.7 + 4.77
S.D. 2.12
Range 3.6 - 12.5 1.0 – 24.0
B Mean + 7.28 + 2.97 +
S.D. 1.99 3.41
Range 2.1 - 10.5 0.8 - 15.2
C Mean + 6.49 + 2.7 + 0.71
S.D. 1.17
Range 5.1 – 8.70 1.1 – 4.0
D Mean + 9.32 + 1.6 2.0 + 0.77
S.D.
Range 7.3- 120. 0.8 – 3.1

DISTRIBUTION OF PATIENTS ACCORDING


TO THEIR THS VALUES.

TSH- Group- Group- Group- Group- %age of


µIU/ml A B C D total
<0.4 0 0 0 0 0%
0.4-3.0 14 12 8 4 76%
3.0-6.1 5 2 2 1 20%
6.1-10.0 0 0 0 0 0%
>10.0 1 1 0 0 4%

CONCLUSION
➢ 4% of the dysfunctional uterine bleeing patients
were hypothyroid (TSH reference range 0.4 - 6.0
µIU/ml).
➢ If we follow new recommendation by the
American Association of Clinical
Endocrinologists (AACE), (TSH reference
range- 0.3 -3.0 µIU/ml), 24% of our patients
would be hypothyroid.
➢ This study needs expantion in the form of
sample size with inclusion of control to establish
a firm association between thyroid dysfunction
and dysfunctional uterine bleeing.
REFERENCES
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patients of menorrhagia. Am. J. obst. And Gynaec.


1989 (March), : 673 – 677.
2. Joshi JV, Bhandarkar SD, Chadha M, Balaiah D,

Shah R. Menstrual irregularities and lactation


failure may precede thyroid dysfunction or goitre. J
Postgrad Med 1993;39:137
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2002: medical guidelines for clinical practice for


the evaluation and treatment of hyperthyroidism
and hypothyroidism. Endocr Pract 8: 457 –469.
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Young: The incidence of thyroid disorders in the
community: a twenty-year follow-up of the
Whickham Survey. The Freeman Hospital,
University of Newcastle, UK Department of Clinical
Geratology, University of Oxford, UK Wansbeck
General Hospital, University of Newcastle, UK,
2008