Prevalence of heavy menstrual bleeding and associations with physical health and wellbeing in low-income and middle-income countries: a multinational cross-sectional study

Sinharoy, SS; Chery, L; Patrick, M; Conrad, A; Ramaswamy, A; Stephen, A; Chipungu, J; Reddy, YM; Doma, R; Pasricha, SR; Ahmed, T; Chiwala, CB; Chakraborti, N; Caruso, BA

Author(s): Sinharoy, SS; Chery, L; Patrick, M; Conrad, A; Ramaswamy, A; Stephen, A; Chipungu, J; Reddy, YM; Doma, R; Pasricha, SR; Ahmed, T; Chiwala, CB; Chakraborti, N; Caruso, BA;
Details: Publication Year 2023-11,Volume 11,Issue #11,Page e1775-e1784
Journal Title: Lancet Global Health
Abstract: BACKGROUND: Data on the prevalence of heavy menstrual bleeding in low-income and middle-income countries (LMICs) are scarce. We aimed to assess the validity of a scale to measure heavy menstrual bleeding and calculate its prevalence in southern Asia and sub-Saharan Africa, and to examine associations between heavy menstrual bleeding and health outcomes. METHODS: Between Aug 2, 2021 and June 14, 2022, we surveyed 6626 women across ten cities (Meherpur and Saidpur, Bangladesh; Warangal, Narsapur, and Tiruchirappalli, India; Kathmandu, Nepal; Dakar, Senegal; Nairobi, Kenya; Kampala, Uganda; and Lusaka, Zambia), including questions on demographics, health, and the SAMANTA scale, a six-item measure of heavy menstrual bleeding. We conducted confirmatory factor analysis to assess construct validity of the SAMANTA scale, calculated the prevalence of heavy menstrual bleeding, and used regression analyses to examine associations of heavy menstrual bleeding with health outcomes. FINDINGS: 4828 women were included in the final analytic sample. Factor analysis indicated a one-factor model representing heavy menstrual bleeding. In the pooled analytic sample, 2344 (48·6%) of 4828 women were classified as experiencing heavy menstrual bleeding, and the prevalence was lowest in Dakar (126 [38·3%] of 329 women) and Kampala (158 [38·4%] of 411 women) and highest in Kathmandu (326 [77·6%] of 420 women). Experiencing heavy menstrual bleeding was significantly associated with feeling tired or short of breath during the menstrual period (risk ratio 4·12 (95% CI 3·45 to 4·94) and reporting worse self-rated physical health (adjusted odds ratio 1·27, 95% CI 1·08 to 1·51), but was not associated with subjective wellbeing (β -3·34, 95% CI -7·04 to 0·37). INTERPRETATION: Heavy menstrual bleeding is highly prevalent and adversely impacts quality of life in women across LMIC settings. Further attention is urgently needed to understand determinants and identify and implement solutions to this problem. FUNDING: Bill & Melinda Gates Foundation, United States Agency for International Development, National Institutes of Health.
Publisher: Elsevier
Keywords: Female; Humans; *Menorrhagia/epidemiology; Developing Countries; Quality of Life; Cross-Sectional Studies; Prevalence; Kenya; Senegal; Uganda; Zambia
Research Division(s): Population Health And Immunity
PubMed ID: 37802092
Publisher's Version: https://doi.org/10.1016/s2214-109x(23)00416-3
Open Access at Publisher's Site: https://doi.org/10.1016/s2214-109x(23)00416-3
Terms of Use/Rights Notice: Refer to copyright notice on published article.
Documents: PIIS2214109X23004163.pdf - (0.13MB, application/pdf)

Creation Date: 2023-11-20 12:03:38

Last Modified: 2023-11-20 12:14:24