Role of thyroid dysfunction in patients with a provisional diagnosis of dysfunctional uterine bleeding

Introduction and Objectives: Dysfunctional uterine bleeding is an abnormal bleeding from the uterus in absence of organic disease of genital tract and demonstrable extragenital cause. Dysfunctional uterine bleeding is synonymous with anovulatory bleeding. Thyroid dysfunction is marked by large number of menstrual aberrations. This study aimed at detecting thyroid dysfunction in patients with a provisional diagnosis of DUB and refers positive cases to physician for further evaluation. METHODS: 100 cases of clinically diagnosed DUB were taken from gynecology OPD and inpatients of Calcutta National Medical College and Hospital. All patients from puberty to premenopausal age groups presenting as menorrhagia, acyclical metropathia, polymenorrhagia, metrorrhagia, oligomenorrhoea, polymenorrhoea and hypomenorrhoea were tested for their thyroid function by free thyroxine (fT4), TSH estimations in their serum. Patients who had clinical symptoms and signs of thyroid disease, already on hormonal treatment, IUCD users, or had bleeding disorders were excluded from the study. RESULTS: 23% of patients who were studied had thyroid dysfunction of which 13% of patients had subclinical hypothyroidism, 7% of patients had hypothyroidism and only 3% of patients had hyperthyroidism. The commonest bleeding abnormality in subclinical hypothyroid patients was polymenorrhoea and menorrhagia. All hyperthyroid cases were oligomenorrhoeic. CONCLUSION: Both subclinical hypothyroid and profoundly hypothyroid cases together were the commonest thyroid dysfunction and menorrhagia was their commonest menstrual abnormality. So this study concludes that biochemical evaluation of thyroid function should be made mandatory in all provisionally diagnosed cases of DUB to detect thyroid dysfunction.