背景:已知甲状腺功能减退会影响广泛的生理系统,包括月经功能,育龄妇女。这项研究旨在全面分析在三级护理中心就诊的女性中甲状腺功能减退与月经不调之间的关系。
方法:这项研究纳入了120名年龄在18-45岁之间出现月经异常的女性。采用方便抽样的方法从妇产科门诊部抽取参与者。甲状腺功能检查在医院的生化实验室进行,包括甲状腺刺激激素(TSH)的评估,游离甲状腺素(FT4),游离三碘甲状腺原氨酸(FT3),甲状腺过氧化物酶抗体(TPOAb)。该研究旨在确定甲状腺功能减退症的患病率及其与各种月经不调的关系,比如月经少发,月经多,月经过多,和闭经.数据分析采用SPSS软件,应用描述性统计,连续变量的皮尔逊相关性,和分类变量的卡方检验。为分析设定P<0.05的显著性水平。
结果:参与者的平均年龄为33.1岁(SD±7.2)。月经不调的分布为60(50%)月经少发,24(20%)月经多,24(20%)月经过多,和12(10%)闭经。在42(35%)的参与者中观察到TSH水平升高(>4.0mIU/L),18(15%)的FT4水平较低(<0.8ng/dL),12(10%)的低FT3水平(<2.5pg/mL),和升高的TPOAb水平(>55IU/mL)在24(20%)。TSH水平升高与月经少发之间存在显着关联(66(55%),p<0.05)和FT4水平降低和月经过多(78(65%),p<0.05)。此外,TPOAb水平升高与闭经显着相关(60(50%),p<0.05)。相关性分析显示TSH水平与月经不调严重程度呈中度正相关(r=0.35,p<0.01)。25%的参与者发现亚临床甲状腺功能减退症,而15%有临床甲状腺功能减退症。
结论:这项研究强调了生育年龄女性甲状腺功能减退与月经不调之间的显著联系。结果强调了对月经异常的女性进行常规甲状腺功能筛查的必要性,便于精确诊断和适当治疗。
BACKGROUND: Hypothyroidism is known to affect a wide range of physiological systems, including menstrual function, in women of reproductive age. This study aims to comprehensively analyze the association between hypothyroidism and menstrual irregularities in women attending a tertiary care center.
METHODS: The study included 120 women aged 18-45 who presented with menstrual abnormalities. Convenience sampling was used to select participants from the outpatient department of obstetrics and gynecology. Thyroid function tests were conducted in the hospital\'s biochemistry laboratory, including assessments of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid peroxidase antibodies (TPOAb). The study aimed to determine the prevalence of hypothyroidism and its association with various menstrual irregularities, such as oligomenorrhea, polymenorrhea, menorrhagia, and amenorrhea. Data analysis was performed using SPSS software, applying descriptive statistics, Pearson correlation for continuous variables, and Chi-square tests for categorical variables. A significance level of p<0.05 was set for the analyses.
RESULTS: The mean age of the participants was 33.1 years (SD ± 7.2). The distribution of menstrual irregularities was 60 (50%) oligomenorrhea, 24 (20%) polymenorrhea, 24 (20%) menorrhagia, and 12 (10%) amenorrhea. Elevated TSH levels (>4.0 mIU/L) were observed in 42 (35%) of the participants, low FT4 levels (<0.8 ng/dL) in 18 (15%), low FT3 levels (<2.5 pg/mL) in 12 (10%), and elevated TPOAb levels (>55 IU/mL) in 24 (20%). A significant association was found between elevated TSH levels and oligomenorrhea (66 (55%), p<0.05) and between reduced FT4 levels and menorrhagia (78 (65%), p<0.05). Additionally, elevated TPOAb levels were significantly associated with amenorrhea (60 (50%), p<0.05). The correlation analysis showed a moderately positive correlation between TSH levels and the severity of menstrual irregularities (r=0.35, p<0.01). Subclinical hypothyroidism was detected in 25% of the participants, while 15% had clinical hypothyroidism.
CONCLUSIONS: This study underscores a notable link between hypothyroidism and menstrual irregularities in women of reproductive age. The results highlight the necessity of routine thyroid function screenings for women experiencing menstrual abnormalities, facilitating precise diagnosis and suitable treatment.