Published: 2017-05-25

Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

Jovita Deepthy John, Vimala Damodaran, Shankar Radhakrishnan


Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.

Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.

Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.

Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.


AUB, Prolactin, Thyroid function test

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Mazzaferri EL. Evaluation and management of common thyroid disorders in women American J Obstet Gynaecol. 1997;176(3):144-9.

Sharma N, Sharma A. Thyroid profile in menstrual disorders. JK Science. 2012;14(1):14-7.

Abraham R, Murugan VS, Pukazhvanthen P. Thyroid disorders in women of puducherry. Indian J Clin Biochem. 2009;24(1):52-9.

Steiner RA, Fink D. Abnormal menstrual bleeding. Schweiz Rundsch Med Prax. 2002;91:1967-74.

ACOG practice bulletin: management of anovulatory bleeding. Int J Gynaecol Obstet. 2001;72:263-71.

Nesse R. Abnormal vaginal bleeding in peri-menopausal women. Am Family Physician. 1989;40:185.

Thomas R, Reid RL. Thyroid diseases and reproductive dysfunction. Obstet Gynaecol. 1987;70:789-98.

Mazzaferri EL. Evaluation and management of common thyroid disorders in women. Am J Obstet Gynaecol. 1997;176(3):144-9.

Kochupillai N. Clinical endocrinology in India. Curr Sci. 2000;79:1061-7.

Hollowell JG, Staehling NW, Flanders WD. Serum TSH, T4 and thyroid antibodies in the United States population (1988 to 1994): National health and nutrition examination survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-99.

Padmaleela K, Vimala T, Lavanya KM, Kiranmai D. Thyroid disordrs and dysfunctional uterine bleeding (DUB) among reproductive age group women. A cross sectional study in a tertiary care hospital in Andhra Pradesh, India. Int J Med Pharm Sci. 2013;4(1):41-6.

Nawroth F. Hyperprolactenemia and the regular menstrual cycle in asymptomatic women: should it be treated during treatment for infertility? Reprod Biomed Online. 2005;11(5):581-8.

Bragiota SI, Bonotis KS, Messinis IE, Angelpoulos NV. The effects of antipsychotics on prolactin levels and women’s menstruation. Schizophr Res Treat. 2013:2013:502697.

Narula ER; Menstrual Irregularities. J Obstet Gynecol India. 1967;17:164.

Pahwa S, Gupta S, Kumar J. Thyroid dysfunction in dysfunctional uterine bleeding. J Adv Res Biol Sci. 2013;5(1):78-83.

Kumar AHS, Saravanan S. A study of prevalence of thyroid disorders in patients with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):1036-9.

Pilli GS, Sethi B, Dhaded AV, Mathur PR. Dysfunctional uterine bleeding. J Obstet Gynecol India. 2001;52(3):87-9.

Deshmukh PY, Boricha BG, Pandey A. The association of thyroid disorders with abnormal uterine bleeding.Int J Reprod Contracept Obstet Gynecol. 2015;4(3):701-8.

Doifode CD, Fernandes K. Study of thyroid dysfunction in patients with dysfunctional uterine bleeding. J Obstet Gynecol India. 2001;51:93-5.

Singh L, Agarwal CG, Choudhary SR, Mehra P, Rajan Khare. Thyroid profile in infertile woman. J Obstet Gynecol India. 1990;40:248.

Wilansky DL, Grisesman B. Early hypothyroidism in patients with menorrhagia Am J Obstet and Gynaecol. 1990;163(2):697.

Sruthi T, Shivanna SB. Prevalence of hypothyroidism in patients with provisional diagnosis of DUB, J of Evolution of med and dental sciences. 2014;3(1):2967-72.

Lee DY, Oh YK, Yoon BK, Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol. 2012;206(3):213.

Mah PM, Webster J. Hyperprolactinemia: etiology, diagnosis, and management. Semin Reprod Med 2002;20(4):365-74.

Serri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ. 2003;169(6):575-81

Eftekhari N, Mirzaei F, Karimi M. The prevalence of hyperprolactinemia and galac- torrhea in patients with abnormal uterine bleeding. Gynecol Endocrinol. 2008; 24(5):289-91.

Shin SY, Lee YY, Yang SY, Yoon BK, Bae D, Choi D. Characteristics of menstruation related problems for adolescents and premarital women in Korea. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):236-42.

Raber W, Gessl A, Nowotny P, Vierhapper H. Hyperprolactinaemia in hypothyroid-ism: clinical significance and impact of TSH normalization. Clin Endocrinol (Oxf). 2003;58(2):185-91.

Refetoff S, Fang VS, Rapoport B, Friesen HG. Interrelationships in the regulation of TSH and prolactin secretion in man: effects of L-dopa, TRH and thyroid hormone in various combinations. J Clin Endocrinol Metab. 1974;38(3):450-7.