Utility of Measuring TSH Levels in Patients Presenting With Abnormal Uterine Bleeding [34G

Abstract

INTRODUCTION: Abnormal uterine bleeding (AUB) affects 9 to 14% of reproductive aged women. Previous studies have demonstrated an increased prevalence of menstrual abnormalities in patients with thyroid disease. The American College of Obstetricians and Gynecologists recommends thyroid stimulating hormone (TSH) screening in patients with AUB. There, however, is no published data evaluating the prevalence of thyroid disease among women presenting with AUB. The purpose of this study is to determine the prevalence of thyroid disease in patients with AUB presenting to a gynecology clinic. METHODS: This is a retrospective case series of patients aged 18 to 50 years that presented with AUB to the gynecology clinic. Patients were identified through review of the electronic medical record (EMR) from January 2012 to June 2016. Two hundred and three patients meeting study criteria for inclusion were analyzed and the prevalence of abnormal TSH was calculated. RESULTS: Thirteen patients (6.4%) were identified with abnormal TSH values. These patients were diagnosed though subsequent testing with subclinical hyperthyroidism (3.4%), subclinical hypothyroidism (0.49%), clinical hypothyroidism (0.49%), and clinical hyperthyroidism (0.49%). The majority of these patients did not have an established diagnosis for AUB (AUB-N) in the EMR. Five patients (38.5%) were diagnosed with AUB-O (ovulatory dysfunction). CONCLUSION: In this patient population with AUB, the prevalence of thyroid disorders was not increased as compared to the expected prevalence of thyroid disease in general female population. Routine measurement of TSH identified few patients with clinical thyroid disease.