ASSOCIATION OF HYPOTHYROIDISM IN POLYCYSTIC OVARIAN SYNDROME

Abstract

ABSTRACT: AIM: Finding the prevalence of hypothyroidism in PCOS and to determine the association between hypothyroidism and various clinical and laboratory parameters in PCOS. SETTING: The study was conducted as a prospective observational study on 196 USG diagnosed cases of PCOS who attended the outpatient wing of MKCG Medical College Hospital, Berhampur, Odisha, India. METHODS: All the USG proven cases of PCOS were subjected to investigations like FSH, LH, FBS, PPBS, Serum Insulin, TSH, Free T3, Free T4. After an overnight fasting, basal venous blood sample was taken. TFT including TSH, Free T3 and Free T4 was estimated using chemiluminescence method. According to this, TSH normal range was taken as 0.34-4.25 µIU/ml, Free T3 normal range was 2.4-4.2 pg/ml, Free T4 normal range was 0.8-1.7 ng/dl137. TSH above 4.25 µIU/ml, Free T3 below 2.4 pg/ml and Free T4below 0.8 ng/dl was considered as overt hypothyroidism and high TSH with normal Free T3 and Free T4 are considered as subclinical hypothyroidism. RESULTS: The mean age of presentation was 27.28± 10.56 years. 78.57% of cases had menstrual complaints. 20.40 % 0f cases had Secondary Amenorrhoea, 56.12 % had Oligomenorrhoea, 2.04 % had Polymenorrhoea and 21.42% had normal menstrual cycles. 76.53 % of cases had Hyperandrogenism. 66.32 % had hirsuitism, out of which 69.23 % had mild hirsuitism, 29.23 % had moderate hirsuitism and 1.53 % had severe hirsuitism. 31.63% of cases had Acne.70 % of married cases had Infertility. Out of that 79.59 % had primary infertility and 20.40 % had secondary infertility. 38.77 % had infertility of duration 1-2 years, 51.02 % had infertility of 3-5 years and 10.20 % had infertility of >5 years. 64.28 % of cases had increased BMI (≥25 kg/m2). The prevalence of hypothyroidism in PCOS was 13.26 %. Out of that 57.69 % had subclinical hypothyroidism and 42.30 % had overt hypothyroidism. 96.15 % of PCOS with hypothyroidism had menstrual irregularities like oligomenorrhoea and secondary Amenorrhoea. This association was found to be statistically significant. 96.15 % of PCOS with hypothyroidism had features of hyperandrogenism like acne and hirsuitism. This association was found to be statistically significant.84.61 % of PCOS with hypothyroidism had increased BMI (≥25 kg/m2.) This association was found to be statistically significant. PCOS and Hypothyroidism are closely related. CONCLUSION: There is increased prevalence of hypothyroidism in PCOS. The relationship between thyroid profile and PCOS is being tried to be explored more and thus the problems of PCOS can be solved to some more extent.