PREVALANCE OF THYROID ABNORMALITY IN PERIMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING AND ITS ENDOMETRIAL PATTERN

Background And Purpose Abnormal uterine bleeding is a common gynaecological problem in women which signicantly affects the quality of life. The prevalence increases with age peaking just prior to menopause. In perimenopausal age, variation in normal cyclical pattern may be due to physiological hormonal changes or pathological. Most ovulatory dysfunction can be traced to endocrinopathies mainly thyroid disorders. It can present as spectrum of menstrual abnormalities ranging from amenorrhoea, infrequent bleeding to episodes of extreme heavy menstrual bleeding. Thyroid disorders are one of the preventable causes and if properly diagnosed, unnecessary surgical interventions can be avoided. Methods: This is a cross sectional study, conducted in the SAThospital, Thiruvananthapuram, where women in age group of 45-55 with abnormal uterine bleeding attending gynaecology OP or as IP, for a period of one year after excluding cervical or genital infections, pregnancy and related causes of bleeding per vagina (PV) and postmenopausal bleeding were selected. Thorough history taking clinical examination and investigations including imaging, TSH, FT3, FT4 were done using questionnaire. Endometrial samples among those with thyroid abnormality were obtained. Data was analysed and statistical test of signicance calculated by chi square test. ResultsIn our study, 31.7% women with AUB was hypothyroid and 9.5% women were hyperthyroid. The most common pattern of perimenopausal AUB was frequent cycles, which was prolonged, irregular and associated with heavyow. Irregular cycles were noted in both hyperthyroidism and hypothyroidism which was signicant. 73 percent of women with a thyroid dysfunction had a palpable thyroid. 47.4% women had normal ndings in USG which signify non-structural causes in perimenopausal women which was signicant (p value <0.001). Out of those already diagnosed with thyroid disorder and on regular treatment, 76.7% had symptomatic relief while on treatment. Conclusion Thyroid disorders are prevalent among premenopausal women with AUB. Thyroid disorders should be considered as an important associated factor for menstrual abnormalities even in perimenopausal women. It is important to screen look for thyroid disorders in women coming with abnormal uterine bleeding. These are preventable causes of AUB. Prompt treatment of thyroid disorders enhances the quality of life of women and prevents unnecessary hormonal treatment and surgery