Previous Next

ARCHIVE

№2' 2021

OBSTETRICS AND GYNECOLOGY

International Medical Journal, Vol. 27., Iss. 2, 2021, P. 57−64.

DOI (https://doi.org/10.37436/2308-5274-2021-2-10)

ABNORMAL UTERINE BLEEDING IN WOMEN WITH THYROID GLAND PATHOLOGY (Literature review)

Kharkiv National Medical University of the Ministry of Health of Ukraine, Ukraine

A literature review on abnormal uterine bleeding in gynecological patients with thyroid pathology has been presented. Massive bleeding is an urgent problem of modern gynecology, because it occurs in almost a third of women of childbearing age and compose significant part of surgery. The variety of types and severity of clinical manifestations of abnormal uterine bleeding is a common reason for appointing the erroneous or ineffective treatment. Recent studies have shown an increase of up to 25.0 % of thyroid lesions, including hypothyroidism, in women of reproductive age. Therefore, it is necessary to assess the state of hormonal function of the thyroid gland in the complex of medical and diagnostic management of abnormal uterine bleeding. The biochemical affinity of thyroid hormones and reproductive system leads to an increased dysregulation in the case of damage to at least one of the systems that forms a vicious circle. Common mechanisms of central regulation of hormonal balance determine the importance of studying the pathogenetic mechanisms that arise at the level of the hypothalamic−pituitary−ovarian and hypothalamic−pituitary−thyroid systems. The direct effect of excess or deficiency of thyroid hormones through specific receptors in the ovaries and endometrium forms a direct pathogenetic effect on the development of menstrual disorders and, as a consequence, abnormal uterine bleeding. Implementation of the effects of thyroid−stimulating hormone and triiodothyronine not only affects the formation of structures of the reproductive system at the biochemical and cellular levels, but also causes an impairment of the cascade of hormonal interactions with prolactin, estrogen, progesterone, etc., which are also the triggers of menstrual disorders. Assessment of the state of hormonal function of the thyroid gland is necessary in the complex of medical and diagnostic management of abnormal uterine bleeding.

Key words: abnormal uterine bleeding, pathology of thyroid gland, medical and diagnostic management.

REFERENCES

1. Abnormal Uterine Bleeding / C. L. Benetti−Pinto et al. // Rev. Bras. Ginecol. Obstet. 2017. Vol. 39 (7). P. 358−368. doi: 10.1055/s−0037−1603807

2. Wouk N., Helton M. Abnormal Uterine Bleeding in Premenopausal Women // Am. Fam. Physician. 2019. Vol. 99 (7). P. 435−443.

3. Khafaga A., Goldstein S. R. Abnormal Uterine Bleeding // Obstet. Gynecol. Clin. North Am. 2019. Vol. 46 (4). P. 595−605. doi: 10.1016/j.ogc.2019.07.001

4. Marnach M. L., Laughlin−Tommaso S. K. Evaluation and Management of Abnormal Uterine Bleeding // Mayo Clin. Proc. 2019. Vol. 94 (2). P. 326−335. doi: 10.1016/j.mayocp.2018.12.012

5. Whitaker L., Critchley H. O. D. Abnormal uterine bleeding // Best Pract. Res. Clin. Obstet. Gynaecol. 2016. Vol. 34. P. 54−65. doi: 10.1016/j.bpobgyn.2015.11.012

6. Cheong Y., Cameron I. T., Critchley H. O. D. Abnormal uterine bleeding // Br. Med. Bull. 2017. Vol. 123 (1). P. 103−114. doi: 10.1093/bmb/ldx027

7. Bradley L. D., Gueye N.−A. The medical management of abnormal uterine bleeding in reproductive−aged women // Am. J. Obstet. Gynecol. 2016. Vol. 214 (1). P. 31−44. doi: 10.1016/j.ajog.2015.07.044

8. Bacon J. L. Abnormal uterine bleeding: current classification and clinical management // Obstet. Gynecol. Clin. North Am. 2017. Vol. 44 (2). P. 179−193. doi: 10.1016/j.ogc.2017.02.012

9. Jewson M., Purohit P., Lumsden M. A. Progesterone and abnormal uterine bleeding/menstrual disorders // Best Pract. Res. Clin. Obstet. Gynaecol. 2020. Vol. 69. P. 62−73. doi: 10.1016/j.bpobgyn.2020.05.004

10. Kolhe S. Management of abnormal uterine bleeding − focus on ambulatory hysteroscopy // Int. J. Womens Health. 2018. Vol. 10. P. 127−136. doi: 10.2147/IJWH.S98579

11. Silva J. F., Ocarino N. M., Serakides R. Thyroid hormones and female reproduction // Biol. Reprod. 2018. Vol. 99 (5). P. 907−921. doi: 10.1093/biolre/ioy115

12. Deshmukh P. Y., Boricha B. G., Pandey A. The association of thyroid disorders with abnormal uterine bleeding // Int. J. Reprod. Contracept. Obstet. Gynecol. 2015. Vol. 4 (3). P. 701−708. doi: 10.18203/2320−1770.ijrcog20150077

13. Menstrual disorders in thyroid dysfunction / A. Verma, A. P. Kaur, H. K. Shergill, S. Kaur // Eur. J. of Biomedical. 2017. Vol. 4 (2). P. 197−201.

14. Kundoor R., Rani B. S. Thyroid function in abnormal uterine bleeding // Int. J. Reprod. Contracept. Obstet. and Gynecol. 2019. Vol. 8 (6). P. 2270−2274. doi: 10.18203/2320−1770.ijrcog20192416

15. Annaldasula A., Gouroju S. Consideration of thyroid dysfunction for menstrual abnormalities in premenopausal women // Int. J. Integrat. Med. Sci. 2018. Vol. 5 (6). P. 650−654. doi: 10.16965/ijims.2018.116

16. Suman S., Sinha G. An analytical study to evaluate the relationship between thyroid dysfunction and abnormal uterine bleeding // Int. J. Health and Clin. Res. 2020. Vol. 3 (4). P. 189−191.

17. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding / P. Byna, S. Siddula, S. Kolli, M. V. Shaik // Int. J. Res. Med. Sci. 2015. Vol. 3 (11). P. 3250−3253. doi: 10.18203/2320−6012.ijrms20151171

18. Chornen'ka G. M Morfologіchna kharakteristika gіperplastichnikh protsesіv endometrіyu za umov polіmorbіdnostі u zhіnok reproduktivnogo vіku, shcho prozhivayut' na iododefіtsitnіi teritorії // Aktual'nі pitannya pedіatrії, akusherstva ta gіnekologії. 2016. № 1. C. 148−150. doi: 10.11603/24116−4944.2016.1.6034

19. Wang Y., Zhou R., Wang J. Relationship between hypothyroidism and endometrial cancer // Aging Dis. 2019. № 10 (1). P. 190−196. doi: 10.14336/AD.2018.0224

20. Abdel Hamid A. M. S., Borg T. F., Madkour W. A. I. Prevalence of hyperprolactinemia and thyroid disorders among patients with abnormal uterine bleeding // Int. J. Gynecol. Obstet. 2015. № 131 (3). P. 273−276. doi: 10.1016/j.ijgo.2015.05.035

21. Yuz'ko O. M. Porushennya funktsії shchitopodіbnoї zalozi v zhіnok іz bezplіddyam ta anomal'nimi matkovimi krovotechami // Klіnіchna ta eksperimental'na meditsina. 2018. № 17 (3, 65). S. 109−112. doi: 10.24061/1727−4338.XVII.3.65.2018.142

22. Effect of antithyroid antibodies on women with recurrent miscarriage: A meta−analysis / J. Xie et al. // Am. J. Reprod. Immunol. 2020. № 83 (6). P. e13238. doi: 10.1111/aji.13238

23. Chaudhary A., Bhatia B. K. Relationship between thyroid disorder and abnormal menstrual bleeding // Int. J. Cur. Res. Rev. 2021. № 13 (02). P. 29−32. doi: 10.31782/IJCRR.2021.13216

24. Ma B. J. Excessive uterine bleeding in a non−compliant patient with profound hypothyroidism: a case report and review of the literatures // J. of Medical Cases. 2016. № 7 (6). R. 234−238. doi: 10.14740/jmc2502w

25. Romanenko T. G., Chaika O. І. Osoblivostі menstrual'noї funktsії u zhіnok z bezplіdnіstyu na tlі patologії shchitopodіbnoї zalozi // Zdorov'e zhenshchiny. 2017. № 6. C. 40−44. doi: https://doi.org/10.15574/hw.2017.122.40

26. Analіz klіnіko−anamnestichnikh chinnikіv rozvitku genіtal'nogo endometrіozu na tlі tireoїdnoї disfunktsії / B. V. Khabrat, A. B. Khabrat, O. O. Litvak, B. M. Lisenko // Ukr. zhurn. meditsini, bіologії ta sportu. 2018. № 3 (6). S. 167−179. doi: 10.26693/jmbs03.06.167

27. Semenyuk L. M., Litvak O. O., Naustinna L. S., Giryavenko O. Ya. Strukturno−metabolіchnі osoblivostі budovi endometrіya u zhіnok pіzn'ogo reproduktivnogo vіku z dobroyakіsnimi tireopatіyami / M. Є. Yarots'kii ta іn. // Endokrinologіya. 2016. № 21 (1). S. 51−56.

28. Somani S. R., Somani S. G. Study of thyroid dysfunction in premenopausal women with abnormal uterine bleeding // Int. J. Sci. & Res. 2015. № 4 (7). P. 487−489.