Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study

Mehmet Çopuroğlu; Özge Baykan Çopuroğlu; Dilek Bayraktar; Derya Koçer

doi:10.32322/jhsm.1938261

Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study

Abstract

Aims: To examine the association between thyroid dysfunction and bleeding severity, anemia burden, and management outcomes in perimenopausal women with abnormal uterine bleeding (AUB). Methods: In this retrospective cohort study, 742 perimenopausal women aged 40-55 years with AUB were evaluated between January 2014 and December 2024. Thyroid status was categorized as euthyroid, subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, or overt hyperthyroidism based on serum thyroid-stimulating hormone and free thyroxine levels. Severe AUB, anemia, and management outcomes (iron therapy, blood transfusion, and procedural interventions) were analyzed using multivariable logistic regression adjusted for demographic and metabolic covariates. Receiver operating characteristic analyses were used to explore the standalone discriminatory performance of thyroid-stimulating hormone for severe AUB and moderate-to-severe anemia. Results: Thyroid dysfunction was identified in 29.4% of participants. Severe AUB and moderate-to-severe anemia were more frequent among women with subclinical and overt hypothyroidism. Thyroid dysfunction was independently associated with severe AUB (aOR 2.21; 95% CI 1.54-3.18), anemia (aOR 1.89; 95% CI 1.33-2.68), and escalation of care (aOR 1.97; 95% CI 1.28-3.02), as well as increased likelihood of iron therapy and blood transfusion. A thyroid-stimulating hormone threshold near 4.0 mIU/L showed moderate discrimination for severe AUB and anemia and should be interpreted as an exploratory risk-enrichment value rather than a definitive diagnostic or treatment cut-off. Conclusion: Thyroid dysfunction, particularly subclinical hypothyroidism, was independently associated with increased bleeding severity, anemia burden, and greater healthcare utilization in perimenopausal AUB. However, given the retrospective observational design, these findings do not establish causality.

Keywords

Ethical Statement

The study protocol was approved by the Ege University Medical Research Ethics Committee (Decision No: 26-2T/31; Date: 05 February 2026). All procedures were conducted in accordance with the Declaration of Helsinki and its later amendments. Due to the retrospective design of the study and the use of anonymized data, the requirement for informed consent was waived by the ethics committee.

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Mehmet Çopuroğlu ^*
0009-0008-2375-6253
Türkiye

Özge Baykan Çopuroğlu
0000-0003-1014-8845
Türkiye

Dilek Bayraktar
0000-0002-3200-7456
Türkiye

Derya Koçer
0000-0002-6780-6776
Türkiye

Publication Date

July 20, 2026

Submission Date

April 26, 2026

Acceptance Date

July 5, 2026

Published in Issue

Year 2026 Volume: 9 Number: 4

DOI

https://doi.org/10.32322/jhsm.1938261

IZ

https://izlik.org/JA88XR68DE

Cite

RIS / Bibtex

APA

Çopuroğlu, M., Baykan Çopuroğlu, Ö., Bayraktar, D., & Koçer, D. (2026). Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study. Journal of Health Sciences and Medicine, 9(4), 1134-1139. https://doi.org/10.32322/jhsm.1938261

AMA

1.Çopuroğlu M, Baykan Çopuroğlu Ö, Bayraktar D, Koçer D. Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study. J Health Sci Med / JHSM. 2026;9(4):1134-1139. doi:10.32322/jhsm.1938261

Chicago

Çopuroğlu, Mehmet, Özge Baykan Çopuroğlu, Dilek Bayraktar, and Derya Koçer. 2026. “Subclinical Thyroid Dysfunction and Clinical Severity in Perimenopausal Abnormal Uterine Bleeding: A Retrospective Cohort Study”. Journal of Health Sciences and Medicine 9 (4): 1134-39. https://doi.org/10.32322/jhsm.1938261.

EndNote

Çopuroğlu M, Baykan Çopuroğlu Ö, Bayraktar D, Koçer D (July 1, 2026) Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study. Journal of Health Sciences and Medicine 9 4 1134–1139.

IEEE

[1]M. Çopuroğlu, Ö. Baykan Çopuroğlu, D. Bayraktar, and D. Koçer, “Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study”, J Health Sci Med / JHSM, vol. 9, no. 4, pp. 1134–1139, July 2026, doi: 10.32322/jhsm.1938261.

ISNAD

Çopuroğlu, Mehmet - Baykan Çopuroğlu, Özge - Bayraktar, Dilek - Koçer, Derya. “Subclinical Thyroid Dysfunction and Clinical Severity in Perimenopausal Abnormal Uterine Bleeding: A Retrospective Cohort Study”. Journal of Health Sciences and Medicine 9/4 (July 1, 2026): 1134-1139. https://doi.org/10.32322/jhsm.1938261.

JAMA

1.Çopuroğlu M, Baykan Çopuroğlu Ö, Bayraktar D, Koçer D. Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study. J Health Sci Med / JHSM. 2026;9:1134–1139.

MLA

Çopuroğlu, Mehmet, et al. “Subclinical Thyroid Dysfunction and Clinical Severity in Perimenopausal Abnormal Uterine Bleeding: A Retrospective Cohort Study”. Journal of Health Sciences and Medicine, vol. 9, no. 4, July 2026, pp. 1134-9, doi:10.32322/jhsm.1938261.

Vancouver

1.Mehmet Çopuroğlu, Özge Baykan Çopuroğlu, Dilek Bayraktar, Derya Koçer. Subclinical thyroid dysfunction and clinical severity in perimenopausal abnormal uterine bleeding: a retrospective cohort study. J Health Sci Med / JHSM. 2026 Jul. 1;9(4):1134-9. doi:10.32322/jhsm.1938261