To explore the relationship between menstrual disorder and thyroid function. Methods The clinical data of 1 495 patients enrolled in Endocrine Center of Gynaecology from January 4, 2006 to March 2, 2011 were analyzed. Patients filled in menstrual history- in details and the levels of thyroid stimulating hormone ( TSH ), free triiodothyronine ( FT3 ) and free thyroxine ( FT4 ) were measured. Results The incidence of abnormal thyroid function was 13.4％ in patients with menstrual disorder and infertility. There was no statistical difference in menstruation disorder between patients of normal thyroid function and abnorrmal thyroid function( P ＝ 0. 107 ), but the incidence of menstrual disorder in thyroid dysfunctional patients was 1.49 times that of normal thyroid functional cases. There was no statistical difference in menstruation disorder among different thyroid functional cases( P ＞ 0.05 ). The incidence of menstrual disorder in subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism and hyperthyroidism was 1.27, 3. 31, 1.40 and 2. 31 times respectively that of normal function. There was statistical difference in hypomenorrhea between patients with hyperthyroidism and normalthyroid function( P ＝ 0.025 ). The incidence of abnormal uterine bleeding and oligomenorrhea in patients with subclinical hypothyroidism was 1.36 and 1.34 times respectively that of normal cases. The incidence of amenorrhea in hypothyroidism was 5.96 times that of normal thyroid functional cases. The incidence of hypomenorrhea in subclinical hyperthyroidism and hyperthyroidism was 3.42 and 10.3 times respectively. TSH, FT3 and FT4 levels did differ between patients with different menstrual disorder( P ＜ 0. 001 ). Conclusion Hyperthyroidism or hypothyroidism can cause menstrual disturbances. Hypothyroidism is associated mainly with amenorrhea or oligomenorrhea, and subclinical hypothyroidism is associated mainly with abnormal uterine bleeding and oligomenorrhea. Menstrual disorder mainly featured as hypomenorrhea is associated with hyperthyroidism and subclinical hyperthyroidism.%目的 探究月经失调形式和甲状腺功能(甲功)之间的联系.方法 系列分析2006年1月4日至2011年3月2日妇科内分泌中心就诊的1 495例患者的临床资料,均填写详细病史表格及检测促甲状腺激素、游离三碘甲状腺氨酸与游离甲状腺素水平.结果 ①临床月经失调和不育患者在系列病例中甲功异常发生率为13.4%;②甲功正常与甲功异常的月经分布情况无统计学差异(P=0.107).但甲功异常者发生月经失调率是甲功正常者的1.49倍;③不同甲状腺功能状态下的月经分布情况均无统计学差异(P＞0.05).但甲亢者发生月经失调率是甲功正常者的2.31倍.亚甲亢者是甲功正常的1.40倍.亚甲减者是甲功正常的1.27倍.甲减者发生月经失调率最高,是甲功正常的3.31倍;④甲亢与甲功正常者相比,月经过少发生率有统计学差异(P=0.025).亚甲减者发生子宫异常出血率和月经稀发率分别是甲功正常者的1.36倍和1.34倍;甲减者发生闭经率最高,是甲功正常者的5.96倍;亚甲亢和甲亢发生月经过少率均最高,分别是甲功正常者的3.42倍和10.3倍;⑤各类与甲功异常类型联系最密切的月经失调患者的促甲状腺激素、游离三碘甲状腺氨酸与游离甲状腺素水平均有统计学差异(P＜0.001).结论 甲状腺功能低落或亢进均有可能发生月经失调.甲减合并的月经失调类型总体偏于月经稀发和闭经.亚甲减与合并子宫异常出血和月经稀发的发生都较密切.甲亢和亚甲亢的月经失调类型均以月经过少为主.
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