Abstract

STUDY OF IMPACT OF PULMONARY AND GENITAL TUBERCULOSIS ON MENSTRUAL PATTERN OF WOMEN IN A TERTIARY CARE REFERRAL CENTRE

Author(s): M. Vijayasree

BACKGROUND TB affects female reproductive health and clinically can present in different ways to tax the ingenuity of the best doctors. In this project, we want to analyse the behaviour of tubercular infection on female reproductive health. Aims and Objectives - 1) To study the impact of pulmonary and genital tuberculosis on menstrual pattern of women (like disordered menstruation). 2) To study of effect of anti-tuberculous treatment on the menstrual pattern of women in terms of oligomenorrhoea and irregular menstruation in a subset of patients. MATERIALS AND METHODS It was a cross sectional observational study done on 100 women attending OPD. They were divided into two groups. GROUP A: 50 women with pulmonary /genital TB with menstrual abnormality and GROUP B: 50 women on ATT and menstrual abnormality. Data was collected in terms of age, socio-economic status, parity, menstrual abnormalities, BMI, symptoms and signs of tuberculosis, associated comorbid conditions, usage of ATT, treatment response in relation to symptomatic relief and defaulters and data was analysed. RESULTS In group A: The majority, 22% were in the age group of 26-30 years. In Group B: The majority 26% were in the age group of 15-20 years. Most women in both the groups were in middle class- 46% and 38% respectively. Among GROUP A: one third 32% were nulliparous, where as in GROUP B, 38% were in para 3 group. Among GROUP A: 46% had normal cycles, 28% had irregular cycles. Among GROUP B: 72% had normal cycles, only 16% had irregular cycles. Group A: 72% were below 50 kgs, Group B: 84% were less than 50kgs. Group A: 70% had loss of appetite & weight, Group B: 82% had loss of appetite and weight. Group A: 50% had anaemia, 8% had HIV infection, 2% had thyroid disorders and 40% were without any comorbid conditions. Whereas in Group B: only 26% had anaemia, 14% had HIV infection, 4% had associated diabetes and 56% were without any comorbidity. In Group A: Only 10% completed the course, 42% are still using ATT, 34% were Defaulters and 14% were having multidrug resistance. Whereas in Group B: 56% completed the course, 44% were using drugs, there were no women with multidrug resistance and none of them were defaulters. In Group A: 66% had normal cycles where as 92% had normal menstruation after treatment in Group B. CONCLUSION Genital TB is a major cause of infertility in women, and prevalence is generally underestimated because of the asymptomatic nature of the infection and diagnostic challenges. Screening for genital TB needs to be a part of evaluation of infertility and menstrual abnormalities. Hence, early diagnosis and correct treatment is vital to avoid complications and to restore fertility.