Thyroid Dysfunction In Women Research Articles

The Prevalence of Thyroid Dysfunction in Women of Sub Himalayan Region Undergoing Routine Health Screening

The Prevalence of Thyroid Dysfunction in Women of Sub Himalayan Region Undergoing Routine Health Screening

Clinicopathological Evaluation of Thyroid Dysfunction in Women with Abnormal Uterine Bleeding

Introduction: Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Regular cyclic menstruation results the choreographed relationship between the endometrium and its regulating factors. Any type of disturbance between the regulatory mechanism of pituitary ovarian axis or pelvic diseases results in abnormal uterine bleeding. 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. Objectives: To evaluate the thyroid dysfunction in patients with abnormal uterine bleeding. Materials and Methods: This cross sectional study was conducted in Department of obstetrics & gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from April 2023 to December 2023. Women with abnormal uterine bleeding were included in the study. Sample was selected by purposive sampling. Sample size was 100. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Data was collected by using a semi-structured questionnaire. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result was presented in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Results: In this study, the maximum numbers of cases (43.0%) were between 26-35 years age group. Mean age was 29.57 ± 8.27 years. Large numbers of respondents came from urban area (58%). On evaluation of types & causes of AUB, maximum patient belongs to AUB-L (leiomyoma) group (53%) followed by AUB-A (adenomyosis) (28%); AUB-P (polyp) (8%); AUB-O (ovulatory) (9%) and AUB-M (malignancy) (2%). Present study showed that prevalence of thyroid disorders is 26% in AUB patients. The prevalence of Hypothyroidism was 18% and Hyperthyroidism was 8%. Thyroid dysfunction is associated with menstrual abnormalities in females of all age groups. Conclusion: Abnormal uterine bleeding has a strong association with thyroid disorders. The most common type of disorder is subclinical hypothyroidism. Thus, all patient of AUB must be evaluated for thyroid dysfunction. Medicine Today 2023 Vol.36 (1): 1-6

1943 Thyroid dysfunction and its relationship with cardiometabolic risk in a South American cohort, cross-sectional study

Abstract Introduction A growing body of evidence suggests that metabolic syndrome is associated with endocrine disorders, including thyroid dysfunction. Thyroid dysfunction in patients with metabolic syndrome may further increase the risk of cardiovascular disease, thus increasing mortality. This study was conducted to assess thyroid function in patients with metabolic syndrome and to assess its relationship to components of metabolic syndrome. Methods A cross-sectional study was carried out among 170 geriatric patients. Anthropometric measurements (height, weight, waist circumference) and blood pressure were taken. Fasting blood samples were analysed for glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, and thyroid hormones (triiodothyronine, thyroxine, and thyroid-stimulating hormone). Results Thyroid dysfunction was observed in 31.9% (n = 54) of the patients with metabolic syndrome. Subclinical hypothyroidism (26.6%) was the main thyroid dysfunction, followed by overt hypothyroidism (3.5%) and subclinical hyperthyroidism (1.7%). Thyroid dysfunction was much more common in women (39.7%, n = 29) than in men (26%, n = 25), but not statistically significant (p = 0.068). The relative risk of having thyroid dysfunction in women was 1.525 (CI: 0.983-2.368) compared to men. Significant differences (p = 0.001) were observed in waist circumference between patients with and without thyroid dysfunction and HDL cholesterol that had a significant negative correlation with thyroid-stimulating hormone. Conclusion Thyroid dysfunction, particularly subclinical hypothyroidism, is common among patients with metabolic syndrome and is associated with some components of metabolic syndrome (waist circumference and HDL cholesterol). Keywords: metabolic syndrome, hypothyroidism, cardiovascular diseases.

Thyroid dysfunction in women with metabolic syndrome and type 2 diabetes

The most common endocrinopathies are pathology of the thyroid gland and diabetes. Thyroid hormones affect glucose metabolism in diabetes, just as diabetes affects thyroid functionObjective. The aim of this study was to explore the relationship between components of the metabolic syndrome, thyroid function, and IL-6 levels in patients with type 2 diabetes.Material and methods. We examined 65 women with type 2 diabetes (average age – (45±0.88) years), and 30 practically healthy women of the control group (average age – (44.14 ± 0.74) years). All patients underwent clinical, anthropometric and biochemical examination. The level of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, antibodies to thyroperoxidase, glucose, glycated hemoglobin, HOMA index, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol were determined. The research was carried out on a Cobas 6000 biochemical analyzer using Roche reagents. In all patients, the level of IL-6 was determined by the method of solid-phase enzyme immunoassay.Results. Among all examined, 19 (29.2%) women were found to have subclinical hypothyroidism on the background of an autoimmune process, their average TSH level was within 4.85±0.21 mU/l, ATPO –572.89±12.29 IU /ml, 9 (13.8%) had hypothyroidism on the background of an autoimmune process, their average TSH level was within 10.10±0.19 mU/l, ATPO –823.76±11.91 IU/ml, and 12 (18.4%) people were carriers of antithyroid antibodies, their average TSH level was within 1.76±0.26 mU/l, ATPO –368.81±14.26 IU/ml. It was found that the average level of IL-6 in patients with type 2 diabetes and AIT was 21.76±0.19 pg/ml, in patients with type 2 diabetes, AIT and SCH – 24.85±0.21 pg/ml, in patients with type 2 diabetes, AIT and HT – 27.43±0.24 pg/ml, patients with type 2 diabetes with normal thyroid function – 18.45±0.19 pg/ml, control group patients - 5,74±1.12 pg/ml. Conclusions. In patients with autoimmune thyroiditis and type 2 diabetes, a relationship of medium strength was found between IL-6 and OT (r=0.32; p<0.05), IL-6 and BMI (r=0.34; p< 0.05), IL-6 and HbA1c (r=0.31; p<0.05), IL-6 and HOMA-IR (r=0.35; p<0.05), IL-6 and TC ( r=0.31; p<0.05) weak correlation between IL-6 and LDL (r=0.21; p<0.05), IL-6 and TG (r=0.18; p <0.05), strong correlation relationship between IL-6 and ATPO (r=0.78; p<0.05), IL 6 and TSH (r=0.62; p<0.05).

Management of Hyperthyroidism during Pregnancy: A Systematic Literature Review

In pregnancy, several physiological changes affect maternal circulating thyroid hormone levels. The most common causes of hyperthyroidism in pregnancy are Graves' disease and hCG-mediated hyperthyroidism. Therefore, evaluating and managing thyroid dysfunction in women during pregnancy should ensure favorable maternal and fetal outcomes. Currently, there is no consensus regarding an optimal method to treat hyperthyroidism in pregnancy. The term "hyperthyroidism in pregnancy" was searched in the PubMed and Google Scholar databases to identify relevant articles published between 1 January 2010 and 31 December 2021. All of the resulting abstracts that met the inclusion period were evaluated. Antithyroid drugs are the main therapeutic form administered in pregnant women. Treatment initiation aims to achieve a subclinical hyperthyroidism state, and a multidisciplinary approach can facilitate this process. Other treatment options, such as radioactive iodine therapy, are contraindicated during pregnancy, and thyroidectomy should be limited to severe non-responsive thyroid dysfunction pregnant patients. In light of this events, even in the absence of guidelines certifying screening, it is recommended that all pregnant and childbearing women should be screened for thyroid conditions.

Prevalence of Thyroid Dysfunction in Women with Dysfunctional Uterine Bleeding in Kano, North-Western Nigeria

Context: Thyroid hormones play a key role in the menstrual and reproductive functions of women. Thyroid dysfunction is marked by a large number of menstrual aberrations. Objective: To determine the incidence of thyroid dysfunction in dysfunctional uterine bleeding (DUB) and its correlation with menstrual patterns. Materials and Methods: The study population consisted of 64 DUB patients aged between 19 and 45 years and an equal number of age-matched women with a normal menstrual cycle. Plasma concentrations of thyroid-stimulating hormone (TSH), free thyroxine (T4), and free triiodothyronine (T3) of the participants were measured. Laboratory analyses were conducted on Elecsys 2010 immunology analyzer. Statistical analysis was performed with Microsoft Excel software, and the data were transferred into IBM SPSS version 21.0 for processing. A P-value of <0.05 was considered significant. Results: Among the 64 women with DUB, 21.9% had thyroid dysfunction, of which 14.1% had overt hypothyroidism, 6.2% had subclinical hypothyroidism, and 1.5% had overt hyperthyroidism. The main menstrual complaint among hypothyroid DUB patients was menorrhagia. The only presentation in hyperthyroidism was oligomenorrhea. Conclusion: The prevalence of abnormal thyroid function in this study was high; therefore, screening of DUB patients for thyroid function abnormalities is suggested.

Greetings From the Editor of Clinical Thyroidology

Greetings From the Editor of <i>Clinical Thyroidology</i>

The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography.

Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates. However, OSCM has high iodine content and long half-life, leading to potential iodine excess. This work aimed to determine the pattern of iodine excess after OSCM HSG and the effect on thyroid function. A prospective cohort study was conducted of 196 consecutive consenting eligible women without overt hypothyroidism or hyperthyroidism. All completed the study with compliance greater than 95%. Participants underwent OSCM HSG (Auckland, 2019-2021) with serial monitoring of thyrotropin (TSH), free thyroxine (FT4), and urine iodine concentration (UIC) for 24 weeks. The main outcome measure was the development of subclinical hypothyroidism (SCH), defined as a nonpregnant TSH greater than 4 mIU/L with normal FT4 (11-22 pmol/L) in those with normal baseline thyroid function. Iodine excess (UIC ≥ 300 μg/L) was almost universal (98%) with UIC peaking usually by 4 weeks. There was marked iodine excess, with 90% and 17% of participants having UIC greater than or equal to 1000 μg/L and greater than 10 000 μg/L, respectively. Iodine excess was prolonged with 67% having a UIC greater than or equal to 1000 μg/L for at least 3 months. SCH developed in 38%; the majority (96%) were mild (TSH 4-10 mIU/L) and most developed SCH by week 4 (75%). Three participants met the current treatment guidelines (TSH > 10 mIU/L). Thyroxine treatment of mild SCH tended to improve pregnancy success (P = .063). Hyperthyroidism (TSH < 0.3 mIU/L) occurred in 9 participants (5%). OSCM HSG resulted in marked and prolonged iodine excess. SCH occurred frequently with late-onset hyperthyroidism occasionally. Regular thyroid function tests are required for 6 months following this procedure.

Vitamin D Level and its Relation with the Newly Diagnosed Diabetic Neuropathy in Women with Hypothyroidism.

Diabetic nephropathy has an important role in the kidneys' function to remove extra fluid and waste products from the body. One way to avoid this disease is the treatment of other diseases, such as diabetes, thyroid gland diseases, and high blood pressure, in addition to maintaining a healthy lifestyle. This study aimed to find the relationship of thyroid hormone, blood biochemical parameters, and anthropometric measurement with the newly diagnosed diabetic neuropathy in women with hypothyroidism. In total, 90 women (with an age range of 35-55 years) were selected, 45 of whom were diagnosed with diabetic neuropathy and had hypothyroidism, and the other 45 were healthy women recruited as the control group. The following parameters were determined: serum triiodothyronine, thyroxine, thyroid stimulating hormone (TSH), 1,25-Dihydroxyvitamin D3 (DHVD3) activities, anthropometric measurement, fasting blood sugar (FBS), hemoglobin A1C (HbA1C), urea, creatinine, and lipid profile. The results showed a significant increase in the body mass index, blood pressure, TSH, FSB, HbA1C, urea, creatinine, and triglycerides of women with newly diagnosed diabetic neuropathy and hypothyroidism, compared to that in the control group (P≤0.05). A significant decrease was also observed in the high-density lipoprotein cholesterol, DHVD3, total triiodothyronine, and total thyroxine of women with newly diagnosed diabetic neuropathy and hypothyroidism, compared to that in the control group (P≤0.05). There was a correlation between vitamin D3 deficiency (VDD) and thyroid dysfunction in women with the newly diagnosed diabetic neuropathy, which indicated VDD is related to thyroid dysfunction and influences newly diagnosed diabetic neuropathy in women.

The Prevalence of Thyroid Dysfunction in Korean Women Undergoing Routine Health Screening: A Cross-Sectional Study.

Background: Women are more likely to experience thyroid diseases than men. However, thyroid dysfunction risk in women undergoing the menopausal transition remains largely unknown. We explored the prevalence of thyroid dysfunction across menopausal stages. Methods: We conducted a cross-sectional study of 53,230 women aged 40 years or older who underwent health screening between 2014 and 2018. Menopausal stages were categorized into 4 based on the Stages of Reproductive Aging Workshop +10 criteria. A multinomial logistic regression model was used to estimate the prevalence ratios (PRs) with confidence intervals [CIs] for thyroid dysfunction in menopausal stages compared with that in premenopause. Results: The prevalence of overt hypothyroidism was significantly increased during late transition and postmenopause; it remained significant after further adjustments for potential confounders (age, center, year of examination, age at menarche, parity, education level, smoking status, alcohol consumption, physical activity, and body mass index) with corresponding multivariable-adjusted PRs [CI] of 1.61 [1.12-2.30] and 1.66 [1.16-2.37] in the late transition and postmenopausal stages, respectively. A significant increase in the prevalence of subclinical hypothyroidism was also observed in the late transition and postmenopausal stage with multivariable-adjusted PRs [CI] of 1.22 [1.06-1.40] and 1.24 [1.07-1.44], respectively. In contrast, subclinical and overt hyperthyroidism were not significantly associated with menopausal stages. Conclusions: In this study of pre- and perimenopausal Korean women, the prevalence of overt and subclinical hypothyroidism was significantly elevated in the late menopausal transition. Future prospective studies are warranted to investigate the clinical and prognostic significance of thyroid dysfunction in women during menopausal transition.

Thyroid Dysfunction after Gonadotropin-Releasing Hormone Agonist Administration in Women with Thyroid Autoimmunity.

GnRH agonists (GnRHa) are a useful tool for pretreatment before artificial endometrial preparation for frozen-thawed embryo-transfer (FET). Their prolonged administration has been associated with thyroid dysfunction, both hyper and hypothyroidism. The aim of this study is to investigate the impact of GnRHa administration on thyroid function in women undergoing artificial endometrial preparation. Seventy-eight euthyroid women undergoing endometrial preparation with hormone replacement for FET were retrospectively reviewed. They were divided into two groups according to pretreatment with GnRHa (group A, 42 women) or with an oral contraceptive (group B, 36 women). Group A was subsequently divided into two subgroups according to thyroid autoimmunity presence. Thyroid function has been evaluated and compared among groups and subgroups. Our results did not show any statistically significant differences in age, body mass index, and basal thyroid stimulating hormone (TSH). Total estradiol dosage, duration of treatment, and endometrial thickness were comparable among groups. When TSH was measured 14 days after embryo transfer, no significant differences between the two groups were reported. Among women of group A, TSH was significantly higher only in women with thyroid autoimmunity. GnRHa seems to be associated with thyroid dysfunction in women with thyroid autoimmunity undergoing hormone replacement therapy for FET.

Subclinical Hypothyroidism in Perimenopausal Abnormal Uterine Bleeding Patients.

Background Abnormal uterine bleeding (AUB) can be very troublesome and is common in women with thyroid dysfunction. The current study aimed to assess the incidence of subclinical hypothyroidism in women with perimenopausal AUB.Methodology A cross-sectional study was conducted at Hayatabad Medical Complex (HMC), Peshawar, Pakistan, between September 2020 to February 2021. All outdoor female patients with complications in the obstetrics and gynecology department, aged between 40 to 55 years of age, and no obvious cervical and genital lesions were included in the study. Patients with a history of suspected inflammatory disease, use of oral contraceptives, and malignant lesions of the cervix were excluded from the study. All cases were evaluated for AUB and their thyroid profile was evaluated. Data regarding menstrual irregularities were recorded in a pre-defined proforma and clinical examination was performed.ResultsA total of 500 women were enrolled with a mean age of 47.2 ± 7.3 years. Of these, 234 (46.8%) women were overweight and the mean levels of the thyroid-stimulating hormone were 4.4 ± 2.5 mIU/L. The mean triiodothyronine and thyroxine were 3.2 ± 1.9 and 1.5 ± 0.7 pmol/L, respectively. The rate of subclinical hypothyroidism was 33%. It was shown that the body mass index was significantly correlated with subclinical hypothyroidism (p=0.03). Furthermore, the rate of oligomenorrhea was significantly higher in patients with subclinical hypothyroidism (p=0.05).Conclusion This study highlights the association between thyroid dysfunction in women with menstrual disorders. Screening and surveillance of thyroid-related abnormalities are warranted in patients with menstrual irregularities to avoid complications of the disease.

Нарушение репродуктивной функции у женщин при аутоиммунном тиреоидите

In the modern conditions of unfavourable environmental situation in most cities, the problem of reproductive disorders (infertility and miscarriage) is becoming increasingly important. Oft en this can occur due to diseases of the endocrine system, in particular, due to autoimmune damage to the thyroid gland. Th e most modern method of combating infertility today is the programme of assisted reproductive technologies (ART), although its eff ectiveness may decrease due to the presence of autoimmune thyroiditis (AIT). Research data on the eff ectiveness of ART in females with AIT are extremely contradictory. However, most evidence suggests that superovulation induction in ART programmes elevates the risk of thyroid dysfunction in women with AIT. Patients with AIT are always at risk of hypothyroidism development in early pregnancy. Th erewith only L-thyroxine treatment is presently provided for women with infertility or miscarriage in combination with AIT who decide to use the in-vitro fertilisation (IVF) programme, which does not always show high effi cacy. Further studies are required to assess the role of AIT in reproductive disorders, as well as to develop alternative methods for AIT correction, including the condition of euthyroidism.

Postpartum Thyroid Dysfunction in Women With Known and Newly Diagnosed Hypothyroidism in Early Pregnancy.

BackgroundHypothyroidism in the first trimester of pregnancy (T1) has great adverse effects on mothers and foetuses. However, few studies have investigated the influence on postpartum thyroid dysfunction. This study aimed to evaluate their long-term effect on postpartum thyroid function within one year after delivery.MethodsIn total, 151 women were recruited from 1496 participants and were classified as newly diagnosed subclinical hypothyroidism (SCH) in T1 (ND-SCH, n=50), previously known SCH before pregnancy (PK-SCH, n=51) and previously known overt hypothyroidism (PK-OH, n=50). Their thyroid functions were dynamically monitored from pre-conception to one-year postpartum.ResultsDuring pregnancy, the first thyroid functions’ test time in T1 were 5-8 gestational weeks. After delivery, the prevalence of postpartum thyroiditis (PPT) was comparable in women with previously known and newly diagnosed hypothyroidism [ND-SCH 62.0% vs PK-SCH 64.7% vs PK-OH 64.0%, P=0.96]. For the ND-SCH group, PPT was significantly related with thyroid-stimulating hormone (TSH) >4.0 mU/L occurring at <8 gestational weeks [OR=8.06, 95% CI, 2.08-31.29] and TSH levels outside 1.0-2.5 mU/L near childbirth [OR=3.73, 95% CI, 1.04-13.41]. For patients with known hypothyroidism before pregnancy (PK-SCH and PK-OH), TSH>2.5 mU/L in T1 [OR=3.55, 95% CI, 1.43-8.81] and TPOAb≥300 μIU/mL [OR=6.58, 95% CI, 2.05-21.12] were associated with PPT. Regardless of whether SCH was diagnosed before pregnancy or in T1, the levothyroxine (LT4) treatment was discontinued at delivery. More than 50% of the patients had to face the hypothyroidism phase of postpartum and restarted LT4 treatment in the first-year follow-up. The logistic regression analysis revealed that TSH elevation occurring at <8 gestational weeks [OR=2.48, 95% CI, 1.09-5.6], TSH levels outside 1.0-2.5 mU/L near childbirth [OR=3.42, 95% CI, 1.45-8.05], and TPOAb≥300 μIU/mL [OR=6.59, 95% CI, 1.79-24.30] were the risk factors.ConclusionTSH elevation at <8 gestational weeks was associated with PPT after delivery in women with known and newly diagnosed hypothyroidism. Especially for SCH patients who stopped LT4 treatment at delivery, unsatisfactory TSH level at <8 gestational weeks and near childbirth, TPOAb≥300 μIU/mL were the risk factors for LT4 retreatment in one-year postpartum.

Homoeopathy lends helping hand for patients having dysfunctional uterine bleeding associated with thyroid dysfunction - study on homoeopathic prescription based on the quality and quantity of menstrual bleeding

Background: Dysfunctional uterine bleeding recently known as abnormal uterine bleeding is one of the significant health problems and social embarrassment for women who seek health care. It has a significant impact on the Quality of Life of women who belong to the reproductive age group, where they are observed to have a lower quality of life. The prevalence of abnormal uterine bleeding in India is reported to be around 17.9% [1]. The prevalence of dysfunctional uterine bleeding along with thyroid dysfunction is about 30% [2].Objective: To study the efficacy of homoeopathic medicines in Dysfunctional Uterine Bleeding associated with Thyroid Dysfunction, prescription based on the Quality and Quantity of the menstrual bleeding. To understand the incidence of Dysfunctional Uterine Bleeding associated with Thyroid Dysfunction in women based on their age and socio-economic status. To understand the incidence of Dysfunctional Uterine Bleeding caused by thyroid dysfunction. To assess the changes in the Thyroid hormone levels with a prescription based on the Quality and Quantity of menstrual bleeding.Method: This was a prospective clinical research study to understand the management of patients having Dysfunctional Uterine Bleeding associated with Thyroid Dysfunction with Homoeopathic medicines based on the Quality and Quantity of the menstrual bleeding. Fifteen (15) clinical cases diagnosed to have Dysfunctional Uterine Bleeding with Thyroid Dysfunction were selected from the IPD, OPD and Rural centres of Sarada Krishna Homoeopathic Medical College and Hospital. The selected cases would be described directly from willing patients in the pre-structured case record format of Sarada Krishna Homoeopathic Medical College and Hospital via case taking and proper investigations. Data were collected with peculiar emphasis on the age, socioeconomic status and the bleeding patterns. The selection of potency and dosage was done based on the 9 Homoeopathic principles. Assessment period was maximum of six months and the follow ups were recorded periodicallyResults: Among the 15 patients, majority of the patients belonged to the age group 26-35yrs. It was observed that the people belonging to the lower socioeconomic status were more susceptible to Dysfunctional Uterine Bleeding associated with Thyroid Dysfunction. Among the 15 cases, 13 cases showed improvement in their menstrual irregularity when the prescription was given based on the Quality and Quantity of the menstrual bleeding. It was noted that a prescription given based on the Quality and Quantity of the menstrual bleeding has an influence on the Thyroid gland secretions, as the Thyroid hormone levels showed an improvement.

Study on Thyroid Dysfunction in Patients of Dysfunctional Uterine Bleeding

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding&#x0D; Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases).&#x0D; The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %.&#x0D; Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made.&#x0D; Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.

Frequency of Thyroid Dysfunction in Women with Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding is one of the major clinical presentation in the gynecology department. There is a wide range of implications of this condition affecting all age groups of females from menarche to menopause. It causes burden on finances in addition to compromising the quality of life of these females. In addition to other systemic symptoms, menstrual abnormality is one of the hallmarks of thyroid dysfunction. Objective: The objective of the study was to determine the frequency of thyroid dysfunction in women with abnormal uterine bleeding. Study Design: Cross sectional study. Settings: The study was conducted at gynecology outpatient department, Sir Ganga Ram Hospital, Lahore Pakistan. Duration: Six months from 15th March 2018 till 15th September 2018. Methodology: All the women presenting with abnormal uterine bleeding in outpatient department of Sir Ganga Ram Hospital fulfilling, the inclusion criteria were included in study. After explaining about the study, consent was obtained from the patient. Demographic details were recorded as well as detailed menstrual history with respect to onset, time duration, estimated amount and any other symptom related to it was obtained. Clinical examination including general physical signs, systemic, gynecological examination and thyroid gland examination was carried out. Blood samples were taken from all these patients with complete aseptic techniques and sent to hospital laboratory for serumT3(triiodothyronine), T4(thyroxine) and TSH (thyroid stimulating hormone) estimation. Data was collected on predesigned proforma. Results: Among the 300 women included in the study, mean age was 36.25+5.89 years, with minimum and maximum age as 18 and 45 years. The mean TSH in these females was 1.97+1.92µIU/ml with minimum and maximum level as 0.1µIU/ml and 7.73µIU/ml. Thyroid dysfunction was seen in 114(38%) of the females while in 186(62%) TSH was in normal range. As in 186(62%) females the TSH was normal. While 36(12%) cases had hypothyroidism and 78(26%) females had hyperthyroidism. Conclusion: It is concluded that there is increased frequency of thyroid dysfunction in women with abnormal uterine bleeding therefore thyroid function tests should be routinely carried out in the women presenting with this complaint.

THYROID DYSFUNCTION IN WOMEN OF REPRODUCTIVE AGE WHO PARTICIPATED IN HOSTILITIES AND SUFFERED CONTUSIONS

The article presents data on the prevalence of thyroid hormonal disorders and the establishment of their relationship between the state of mental health and the functional state of body systems in women who participated in hostilities who suffered contusions. We aimed to assessing the prevalence and effectiveness of the diagnosis of thyroid dysfunction in women of childbearing age with impaired reproductive health who participated in hostilities and suffered contusions, to improve treatment and rehabilitation measures and quality of life of these women.

Evaluation of Thyroid Dysfunction in Women with Gestational Diabetes Mellitus Compared to Healthy Pregnant Women Referred to Kowsar Hospital in Qazvin from 2017 to 2018

Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018.Methods: In this case-control study, 100 women with gestational diabetes mellitus and 100 non diabetic healthy pregnant women who referred to Kowsar Hospital in Qazvin from 2017 to 2018 were selected using the convenience sampling method, and their serum thyroxine, anti-TPO, and TSH levels were determined and compared. Moreover, Apgar scores and anthropometric variables were compared between the two groups.Results: In the present study, there were statistically significant differences between the groups in terms of the TSH level (P < /em>=0.012), assessed by the independent t-test, the thyroxine (P < /em>=0.0001) and anti-TPO (P < /em>=0.008) levels, both examined by the Mann-Whitney test, which associated with high levels of TSH and anti-TPO and low levels of thyroxine in the diabetic group. No differences were found regarding the Apgar scores and anthropometric variables between the groups (P < /em>>0.05).Conclusion: Overall, according to the obtained results, it can be inferred that thyroid dysfunction, realized as hypothyroid with high anti-TPO levels, was more prevalent in women with gestational diabetes mellitus compared to healthy pregnant women.

ASSOCIATION OF THYROID DYSFUNCTION IN WOMEN PRESENTING WITH MENSTRUAL PROBLEMS.

Background; Menstrual disorders frequently affect the quality of life of adolescents and young adult women, especially those who suffer dysmenorrhoea and heavy menstruation. Different studies have associated thyroid dysfunction with menstrual problems. This study was conducted to document the frequency of hypothyroidism in women with menstrual problems. Objective; To determine frequency of thyroid dysfunction in women having menstrual problems at a tertiary care hospital. Material and methods ; All the study cases (227) who meet inclusion and exclusion criteria of my study were taken from OPD of the Department of Gynecology and Obstetrics, Nishtar Hospital Multan. Once registered, 5 ml venous blood sample was taken and sent to the central laboratory of the Nishtar Hospital Multan for serum TSH and T 4 levels by a pathologist having minimum 5 years experience after post-graduation. Hypothyroidism was determined on laboratory report after serum analysis for TSH and T 4. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was noted to be 24.08± 4.65 years. Of these 227 study cases, 134 (59 %) were married while 93 (41%) were unmarried. Mean body mass index (BMI) of our study cases was 22.31 ± 2.70 kg/m 2 , 160 (70.5%) were normal weight, 51 (22.5%) were overweight and 16 (7%) were obese. Secondary amenorrhea was noted in 25 (11%), oligomenorrhea in 42 (18.5%), polymenorrhea in 16 (7%), heavy menstrual bleeding in 59 (26%) and irregular menstrual bleeding in 85 (37.5%). Mean serum TSH level of our study cases was 4.85 ± 0.91 mIU/L while mean T 4 level was noted to be 86.90 ± 38.81 nmol/L and hypothyroidism was noted in 176 (77.5%) of our study cases. Overt hypothyroidism was noted in 75 (33 %) and subclinical hypothyroidism in 101 (44.5%) of our study cases. Conclusion; Very high frequency of thyroid dysfunction was noted in women having menstrual problems in our study. Thyroid dysfunction was significantly associated with residential status, obesity, poor socioeconomic status, level of education and type of menstrual problem. Our study results suggest that women presenting with menstrual problems must be screened for thyroid hormones for proper management of these patients. Keywords; Thyroid dysfunction, Menstrual problems, subclinical hypothyroidism, overt hypothyroidism. DOI: 10.7176/JMPB/67-06 Publication date: August 31 st 2020