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Menstruation has been regarded as the purifying process of the female health system since ancient times. So, any change in the volume or pattern of menstrual bleeding is a cause of concern in women. This concern is heightened not only by the myths and taboos that surround the subject of menstruation, but also by well-orchestrated campaign for early detection of gynecological malignancies.1 Menstrual abnormalities in the absence of any organic pelvic pathology form a group of disorders known as dysfunctional uterine bleeding (DUB) or nowadays more commonly referred to as abnormal uterine bleeding, where there is a dysfunction at any level of the hypothalamo-pituitary-ovarian axis resulting in disturbance in the rhythmical production of hormones by the ovary.2 It may be bleeding without a causative uterine lesion, such as tumor infection or complications of pregnancy, although frequently there may be associated cysts of the ovary. It comprises a major portion of abnormal menstruation cases, being the principal diagnosis in at least 10% of all new outpatient department patients.3 Dysfunctional uterine bleeding is classified by the character of menstrual cycle as ovulatory or anovulatory. Out of all the etiologies, age variations and clinical presentations like thyroid dysfunction (subclinical or clinically evident) are becoming significantly important factors associated with DUB. The thyroid gland is known to play an important role in maintaining a healthy menstrual cycle. The impact of thyroid hormones has been reported to be both direct, through the presence of thyroid hormone receptors on the ovaries, and indirect, through the impact on the secretion of sex hormonebinding globulin (SHBG), prolactin, and gonadotropinreleasing hormone (GnRH). Both hypothyroidism and hyperthyroidism are associated with a variety of changes in reproductive function including delayed onset of puberty, anovulatory cycles, and abnormally high fetal wastage.4 Clinical experiences show increased menstrual flow to be the most common reproductive system manifestation of hypothyroidism. It is seen that women with hypothyroidism had abnormal menstrual pattern, with menorrhagia or heavy menstrual bleeding being the commonest. On the contrary, hyperthyroidism 1Senior Resident, 2Assistant Professor, 3Professor 1Department of Biochemistry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India 2Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India 3Department of Biochemistry, Assam Medical College & Hospital Dibrugarh, Assam, India Correspondence Author: Gautom K Saharia, Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India, Phone: +919864440087, e-mail: gsaharia@yahoo.com ABSTRACT

Thyroid Status in Patients with Dysfunctional Uterine Bleeding in a Tertiary Care Hospital of Assam