Causes of Perimenopause Bleeding and Association with Thyroid Dysfunction: A Cross-Sectional Study

Background & Objective: Perimenopause period is the transitional period 2-8 years before and one year after the last menstrual period. The most common complaint in this period includes abnormal uterine bleeding; the cause may be structural and non-structural, thyroid hormone known to affect reproductive biology. This study was conducted with aim to evaluate the correlation between thyroid disorder and different causes of abnormal uterine bleeding in perimenopause women.Materials & Methods: This cross-sectional study was conducted in Iraq province from September 2023 to April 2025. The sample population were 49 women aged 40-51years old who complain from abnormal uterine bleeding. TFT, CBC; transvaginal ultrasound and endometrial biopsy was performed for the patients. Data were analyzed using SPSS software (version 26). P≤ 0.05 was considered statistically significant.Results: The mean age of participants was 44 years old, with 53.1% (26 women) between 40 and 45, 31(63.3%) multiparous, 38(77.6%) euthyroid, 1(2%) hyperthyroid, and 10(20.4%) subclinical hypothyroid. There was a significant relationship between thyroid function and irregular bleeding (P<0.05). Among women, 19(38.8%) had menorrhagia, 16(32.7%) poly menorrhoea, 10(20.5%) intermittent bleeding, and 4(8.1%) oligo menorrhoea. AUB was caused by dysfunctional uterine bleeding in 24(49%), endometrial hyperplasia (with or without atypia) in 9(18.4%), adenomyosis in 6(12.2%), fibroid in 5(10.2%), and ovarian cyst in 1(2%). Thyroid function did not alter abnormal uterine haemorrhage causes.Conclusion: Most women presented with menorrhagia and poly menorrhea between the age 40-45 years with dysfunctional uterine bleeding being the most common cause, and there was strong association between thyroid dysfunction and abnormal uterine bleeding.