Menstrual irregularity and its associated factors among college students in Ethiopia, 2021

Magnitude and determinants of abnormal uterine bleeding among reproductive-age women in Kombolcha Rejiopolitan Administrative Town, Northeast Ethiopia: a FIGO-based study (2023)

Background

Abnormal uterine bleeding (AUB) is a common reason for women to seek healthcare, affecting their health, quality of life, productivity, and increasing the risk of complications. While menstrual disorders have been studied in Ethiopia, the prevalence and determinants of AUB among reproductive-age women remain poorly understood due to the use of outdated terminology and a lack of standardized approaches, which hinder accurate assessment and comparison with international findings. This study aims to address this gap by assessing the magnitude and determinants of AUB among reproductive-age women in Kombolcha town, Ethiopia, using the 2018 FIGO criteria.

Methods

A community-based cross-sectional study was conducted among 608 reproductive-age women in Kombolcha town from April 20 to May 20, 2023, using systematic random sampling. Data were collected using interviewer-administered structured questionnaires. The data were entered into EPI Data version 4.6 and analyzed using SPSS version 26. All predictor variables with a p-value <0.25 in bivariable analysis were included in multivariable logistic regression. Variables with a p-value <0.05 in the multivariable analysis were considered statistically significant predictors of abnormal uterine bleeding.

Result

This study found that 36.5% of 591 reproductive-age women experienced abnormal uterine bleeding (AUB). Several factors were significantly associated with AUB: Women in late reproductive age (41-49 years) had 4.2 times higher odds of experiencing AUB compared to those in mid-reproductive age (AOR = 4.181, 95% CI: 2.199-7.948). Hypertensive women were 3.71 times more likely to experience AUB (AOR = 3.706, 95% CI: 1.106-12.417). Women with a history of abortion had 2.3 times higher odds of AUB (AOR = 2.345, 95% CI: 1.069-5.147). A history of diagnosed anemia and late menarche (≥15 years) were also significantly associated with increased AUB risk (AOR = 2.939, 95% CI: 1.437-6.010; AOR = 3.824, 95% CI: 2.199-7.948).

Conclusion

This study highlights the significant burden of AUB, with 36.5% of women affected. Healthcare providers should educate patients about lifestyle changes, treatment options, and when to seek emergency care for AUB to improve health outcomes.

The link between tinnitus and menstrual cycle disorders in premenopausal women

This cross-sectional study aimed to explore the association between tinnitus and menstrual cycle disorders in premenopausal women. A total of 558 participants completed a comprehensive questionnaire covering demographics, tinnitus, and gynecological/obstetric history. The analysis investigated the correlation between tinnitus and various menstrual disorders, including dysmenorrhea (primary, secondary, or premenstrual syndrome), as well as different menstrual cycle patterns (regular, hypomenorrhea, menorrhagia, oligomenorrhea, or polymenorrhea). Among the participants, 33% reported experiencing tinnitus, with 74.4% experiencing dysmenorrhea. The most prevalent pathological menstrual pattern was menorrhagia (20%), followed by hypomenorrhea (11.11%). The results revealed a significant increase in tinnitus among premenopausal women with secondary dysmenorrhea (p value < 0.001) or menorrhagia (p value < 0.002) compared with those without tinnitus. Adjustment for confounding variables such as age, income, and psychological health problems did not alter the significant correlations between tinnitus and secondary dysmenorrhea and menorrhagia. Further research is needed to elucidate the nature of this relationship and its underlying mechanisms. Both tinnitus and menstrual disorders can have substantial impacts on the well-being of affected women, and a deeper understanding of these issues could pave the way for improvements in their health care.

Abnormal Uterine Bleeding Among Rural Adolescent Schoolgirls: A Cross-Sectional Study

Background and Objectives: The International Federation of Gynecology and Obstetrics (FIGO) and the American College of Obstetricians and Gynecologists (ACOG) define abnormal uterine bleeding (AUB) as "bleeding from the uterus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy". The impact of AUB on the physical and psychosocial well-being of adolescent girls can be significant. In this study, we aim to investigate the menstrual cycle characteristics in adolescent Sudanese schoolgirls and the prevalence of abnormal uterine bleeding (AUB) and its associated factors. Materials and Methods: A school-based cross-sectional study was conducted in Almatamah locality, Sudan. A questionnaire was used to collect sociodemographic data and menstrual cycle parameters. Weight and height were measured, body mass index (BMI) was calculated, and hemoglobin levels were determined. Logistic regression was also performed. Results: Of the 162 girls in the study, 27.2% had frequent cycles, 3.7% had infrequent cycles, 2.5% had prolonged menses duration, 44.4% had irregular cycles, and 21.0% had heavy menstrual bleeding. The overall prevalence of AUB in the study was 64.8%. None of the investigated factors (chronological age, maternal education or occupation, gynecological age, BMI, and hemoglobin level) were associated with AUB. Conclusions: In conclusion, the prevalence of AUB was high among the study participants, with irregular cycles, frequent cycles, and heavy menstrual bleeding being the most common types.

Prevalence and influencing factors with knowledge, attitude, and practice toward anemia among school-going adolescent girls in rural Bangladesh

BACKGROUND

Anemia is a major public health concern; however, research on anemia and its contributing variables is scarce. To address the gap, we investigated the prevalence and associated factors of anemia in school-aged adolescent girls in rural Bangladesh.

METHODS

We conducted a cross-sectional study in two secondary schools at Chandpur, Bangladesh, from January to April 2022. We randomly selected 422 adolescent girls based on prevalence rates from existing research to ensure reliable estimates and a robust study representation. We performed interviews with a semi-structured questionnaire after receiving ethical permission and written informed consent. In addition, physical examination and anthropometric measurements were done, followed by blood testing to identify anemia. Blood hemoglobin was measured using a spectrophotometric method, and quality control was ensured by validated results with control samples. Univariate with multiple logistic regression was employed for analysis to find the association between anemia and all other variables that were adjusted to control the potential effect of confounding variables.

RESULTS

The overall prevalence of anemia was 37.7% (mild- 33.8% and moderate- 3.9%). In the univariate analysis having a working mother (OR 3.84; 95% CI 1.31-11.26), undernutrition (OR 2.40; 95% CI 1.27-4.52), and irregular lunch consumption (OR 2.15; 95% CI 1.00-4.60) were associated with anemia. Conversely, being a user of a slab latrine (OR 0.61; 95% CI 0.40-0.93) and not weekly consumption of pure milk (OR 0.62; 95% CI 0.41-0.92) were negatively associated with anemia. In multivariate logistic regression analysis, associated factors for prevalent anemia were working mother [adjusted odds ratio (aOR) 7.65; 95% CI 1.97-29.50], slab latrine user (aOR 0.46; 95% CI 0.26-0.79), and irregular lunch consumption (aOR 2.92; 95% CI 1.21-7.03).

CONCLUSION

The prevalence of anemia among adolescent girls in rural Bangladesh remains high with undernutrition. Anemia is associated with working mothers, slab latrine users, and irregular lunch consumers within the studied population.' Thus, policymakers may promote school-based nutritional education and lunch programs with iron supplementation and improve sanitary facilities.

Factors predicting menstrual irregularity among university students in Ho Chi Minh City, Vietnam: A cross-sectional study

Background

University students often face menstrual irregularities, particularly among healthcare students, due to rigorous study environments, such as night duties resembling professional staff responsibilities.

Objective

This study aimed to examine the prevalence of and factors predicting menstrual irregularities among female students in Ho Chi Minh City, Vietnam.

Methods

A cross-sectional study was conducted from April to July 2023 at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP). Data were collected using self-administered questionnaires comprising sections on personal background, menstrual cycles, sleep duration, and academic stress. Descriptive statistics and multiple logistic regression were employed for data analysis.

Results

Approximately 48.3% of participants experienced menstrual irregularities. Overweight or obese students were more likely to experience irregularities compared to those of normal weight (AOR = 7.56, 95% CI = 1.34, 80.8). Nursing majors (including nursing, midwifery, and anesthesia resuscitation nursing) showed a higher likelihood of irregularities compared to other majors (AOR = 2.5, 95% CI = 1.35, 4.13).

Conclusion

This study highlights a significant prevalence of menstrual irregularities among female students. Interventions in nursing education should focus on promoting healthy lifestyles and regular physical activity to manage weight and mitigate menstrual irregularities.

At What Point in the Menstrual Cycle Are the Pelvic Floor Muscles at Their Weakest?

Pelvic floor muscle (PFM) strength is a critical factor for optimal pelvic floor function. Fluctuations in strength values based on different phases of the menstrual cycle (MC) could signify a need for a paradigm shift in evaluating, approaching, and planning training. This research aims to examine and contrast the pelvic floor muscle strength during different phases of the menstrual cycle. A prospective observational study employing digital assessment with the modified Oxford scale and vaginal dynamometry measurements was performed, in order to assess the baseline strength and the contraction strength of the PFMs in eumenorrheic females at three different phases of the MC: the early follicular phase (EFP), the late follicular phase (LFP), and the mid-luteal phase (MLP). During two complete cycles, tympanic temperature and body weight were measured and the urinary luteinizing hormone concentration was tested to determine the time of ovulation. In total, 216 dynamometric measurements of PFM strength were obtained from eighteen nulliparous women (25.72 ± 5.03 years). There were no differences between the baseline strength (p = 0.886) and the contraction strength (p = 0.756) with the dynamometric speculum. In the post hoc analysis, the baseline strength, contraction strength, and strength showed no significant differences between MC phases. As no differences in PFM strength in women were found, the PFMs do not seem to be weaker at any time during the menstrual cycle. It appears that the assessment, establishment, and monitoring of a PFM training program could be initiated at any point in the cycle.

Burden of irregular menstrual cycle and its predictors among reproductive-age women in Ethiopia: Systematic review and meta-analysis

Introduction

Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia.

Methods

International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google, and Google Scholar) and lists of references were employed to search literature in Ethiopia. The random-effects model was used to calculate the odds ratios of the outcome variable using STATA version 18. The heterogeneity of the studies was measured by computing I 2 and p-values. In addition, sensitivity analysis and funnel plots were performed to test the stability of pooled data in the presence of outliers and publication bias.

Results

The review includes 21 studies and 9109 populations. The overall burden of irregular menstrual cycles among reproductive-age women was 35% (95% CI: 30-41) with I 2 = 96.96%. Sleeping for <5 h a day (AOR: 2.49; 95% CI: 1.49-3.49) and a stressful life (AOR: 3.15; 95% CI: 1.44-4.85) were predictors of irregular menstrual cycles.

Conclusion

More than one in every three reproductive-age women in Ethiopia experience irregular menstrual cycles. Sleeping for <5 h a day and stress increase the likelihood of an irregular menstrual cycle, which can be modified by improving sleeping hours and decreasing stress stimulators through psychotherapy.

Abnormal uterine bleeding and its associated factors among reproductive-age women who visit the gynecology ward in Dilla University General Hospital, Southern Ethiopia, 2022

BACKGROUND

Abnormal uterine bleeding, a frequent gynecological problem among women of reproductive age, significantly affects their health and quality of life. Despite its problem, research on its extent and contributing factors in Ethiopia is scarce. Hence, this study is designed to determine the magnitude and factors associated with abnormal uterine bleeding among women visiting Dilla University General Hospital, Dilla, Ethiopia.

METHODS

A cross-sectional study design was conducted with 380 women of reproductive age at Dilla University General Hospital. A systematic sampling method was employed to select the participants for the study. A structured interview administered questionnaire and checklist were used to collect the data. Stata V.14 software was used for cleaning, coding, ensuring completeness and accuracy, and further analysis. Bivariate and multivariable logistic regression analyses were used. Finally, the variables that have a p-value of < 0.05 were considered statistically significant.

RESULTS

In this study, the magnitude of abnormal uterine bleeding was 24.21% (95% CI, 20.14-28.79). History of sexually transmitted disease [AOR = 1.44, 95% CI: (1.33, 4.75)], history of anemia [AOR = 3.92, 95% CI: (1.20, 12.74)]., history of alcohol consumption [AOR = 2.49, 95% CI: (1.22, 5.06)], and perceived stress level [AOR = 1.30, 95% CI: (1.15, 1.69)] were found to be significantly associated with abnormal uterine bleeding.

CONCLUSIONS

The magnitude of abnormal uterine bleeding was 24.2% in the study setting. Factors such as a history of sexually transmitted disease, anemia, alcohol consumption, and perceived stress level were identified as significant risk factors for abnormal uterine bleeding. Addressing these factors is crucial for management. Further research and interventions targeting these risks are needed to enhance health outcomes. The study provides valuable insights for future interventions.

Understanding Adolescent Gynecological Issues: A Cross-Sectional Study at a Tertiary Care Center

BACKGROUND AND OBJECTIVES

Adolescence is a crucial phase in a woman's life, as it signifies the beginning of her reproductive journey. During this time, there are notable variations in sexual development and a sense of caution that can present challenges for healthcare providers. The rationale for studying adolescent gynecological problems lies in the need to understand and address the unique reproductive health challenges faced by young girls. By investigating these issues, researchers and healthcare professionals can develop effective strategies for prevention, early detection, and treatment of gynecological conditions in adolescents. This knowledge is crucial for promoting the overall well-being and reproductive health of young girls, ensuring they receive appropriate care and support during this critical stage of development. This study focuses on identifying the most common gynecological issues in teenagers, exploring the root causes, examining the available treatment options, and understanding how they are managed at a tertiary care facility.  Methods: This cross-sectional observational study took place at a tertiary care center and focused on gynecological issues in adolescent females who sought care at the gynecology department from January 2016 to December 2022. The study participants were categorized into three groups: early adolescence (10-13 years), middle adolescence (14-16 years), and late adolescence (17-19 years) for analysis. Ethical approval was obtained for this hospital-based research, which involved examining, investigating, and treating the study participants.

RESULTS

Out of the 49,700 new female patients, 2000 (4.02%) fell within the specified age range. The average age of the participants was 16.87±2.16, and the majority of them sought help for menstrual issues (63.45%), followed by abdominal discomfort (15.6%) and vaginal discharge (7.2%). Menstrual disorders were the most common concern, with dysmenorrhea and puberty menorrhagia being prevalent issues. Abdominal pain was caused by various factors, such as urinary tract infections, ovarian tumors, pelvic inflammatory disease, endometriosis, and endometrial tuberculosis. The majority of cases were treated conservatively, with only a small percentage requiring surgical intervention.

CONCLUSION

The significance of early detection and intervention in addressing gynecological issues among adolescents is highlighted in the findings of this research, underscoring the necessity for specialized healthcare services that cater to the specific needs of this demographic. Adolescent gynecology plays a crucial role in safeguarding the reproductive health and overall well-being of young women, emphasizing the importance of seeking assistance proactively.

The Impact of Irregular Menstruation on Health: A Review of the Literature

Women are considered to have an irregular menstrual cycle if their cycle length is less than 21 days or more than 35 days, accompanied by less or very severe blood flow. The prevalence of menstrual cycle irregularities varies across countries. Irregular periods can occur due to changes in the body's levels of estrogen and progesterone hormones, which disrupt the normal pattern of the period. Menstrual irregularity has been found to be associated with various diseases and medical conditions, such as metabolic syndrome, coronary heart disease, type 2 diabetes mellitus, and rheumatoid arthritis. Anemia, osteoporosis, psychological problems, impaired quality of life, and infertility have also been recorded. Moreover, a significant correlation between irregular periods and the risk of developing pregnancy-related hypertensive disorders, as well as an increased risk of adverse obstetric and neonatal outcomes, has been proven. Therefore, irregular menstruation is considered an important health indicator among women. Physical, mental, social, psychological, and reproductive problems are often associated with menstrual irregularities. Thus, evaluating the factors associated with irregular menstruation is necessary to determine appropriate preventive and treatment strategies and to decrease the associated health problems. The aim of this review was to define normal and irregular menstruation, their types, and prevalence, to recognize the risk factors and causes of irregular menstruation, and to understand their impact on women's health.