Thyroid dysfunction and menstrual disorders in reproductive-age women: A prospective observational study in a tertiary hospital in Andhra Pradesh, India.
DOI:
https://doi.org/10.51168/5s43wt37Keywords:
Abnormal uterine bleeding, Menstrual disorder, Hypothyroidism, Subclinical hypothyroidism, Thyroid-stimulating hormone, IndiaAbstract
Background
Thyroid dysfunction can disturb the hypothalamic-pituitary-ovarian axis and cause menstrual irregularities in reproductive-age women; early detection is important for accurate diagnosis and timely management. Objectives: To estimate the prevalence of thyroid dysfunction among reproductive-age women presenting with menstrual disorders and to evaluate the association between thyroid hormone categories and specific bleeding patterns.
Methods
A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences (MIMS), Nellimarla, Vizianagaram, Andhra Pradesh, India, from August 2023 to February 2025. Women aged 18–45 years with menstrual irregularities were enrolled (n=160) after applying eligibility criteria and obtaining written consent. Clinical evaluation, pelvic examination, haemoglobin estimation, and transabdominal ultrasonography were performed. Menstrual blood loss was assessed using the pictorial blood loss assessment chart. Serum T3, T4, and thyroid-stimulating hormone (TSH) were measured, and participants were classified as euthyroid, hyperthyroid, hypothyroid, or subclinical hypothyroid. Associations were tested using the chi-square test.
Results
Overall, 33/160 women (20.62%) had thyroid dysfunction: hypothyroidism 22 (13.75%), subclinical hypothyroidism 8 (5.00%), and hyperthyroidism 3 (1.88%). Menorrhagia was the leading menstrual disorder (54, 33.75%), followed by amenorrhoea (47, 29.38%) and polymenorrhoea (36, 22.51%). Parity was significantly associated with thyroid status (p=0.04). Menstrual pattern showed strong associations with T3 (p<0.001), T4 (p<0.001), and TSH (p<0.001) categories; elevated TSH clustered with menorrhagia and polymenorrhoea, whereas low TSH was observed mainly among amenorrhoeic women. Weight gain and constipation were common hypothyroid-suggestive symptoms, while weight loss and fatigue suggested hyperthyroidism.
Conclusion
One in five women with menstrual disorders had biochemical thyroid dysfunction, predominantly hypothyroidism. Thyroid hormone derangements were significantly linked to the type of menstrual disturbance.
Recommendations
Thyroid function testing should be incorporated into the first-line evaluation of menstrual disorders in routine clinic practice, particularly heavy or frequent bleeding and persistent amenorrhoea.
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Copyright (c) 2026 Dr. Durga Devi Meda, Dr . R V Durga Prasad, Dr. Guturu P.R.S.D.S Tejaswini, Dr. D.S.S.K.Raju (Author)
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