HYPOTHYROIDISM IN WOMEN HAVING MENSTRUAL PROBLEMS AT A TERTIARY CARE HOSPITAL

Abstract

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 hypothyroidism 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 T₄ 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/m² , 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 T₄ 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 hypothyroidism was noted in women having menstrual problems in our study. Hypothyroidism was significantly associated with residential status, obesity, poor socioeconomic status, level of education and type of menstrual problem. Subclinical hypothyroidism was more prevalent as compared with over hypothyroidism. Our study results suggest that women presenting with menstrual problems must be screened for thyroid hormones for proper management of these patients.

Keywords; Hypothyroidism, Menstrual problems, subclinical hypothyroidism, overt hypothyroidism.