Determinants of Abnormal Uterine Bleeding and Their Impact on Women's Quality of Life

Abnormal uterine bleeding (AUB) is a common gynecological problem that can substantially impair women's physical, psychological, social, and environmental well-being. Its determinants are multifactorial and include demographic, lifestyle, medical, gynecological, menstrual, and reproductive factors. Objective: To determine the clinical and sociodemographic factors associated with AUB and assess their impact on women's quality of life. Methods: A quantitative, descriptive cross-sectional study was conducted among 100 women with AUB attending Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh, from 1st Jan 2023- 31st dec 2023. Participants were selected by non-probability consecutive sampling. Data were collected using a structured questionnaire covering sociodemographic, lifestyle, nutritional, medical, gynecological, menstrual, and reproductive characteristics. Quality of life was assessed using the WHOQOL-BREF questionnaire. Data were analyzed using descriptive statistics and appropriate inferential tests, with a p-value <0.05 considered statistically significant. Results: The majority of participants (47%) were aged 46–50 years, 64% had normal BMI, 62% were housewives, and 54% resided in urban areas. Mental stress was reported by 73%, while 59% had moderate physical activity and 66% followed a non-vegetarian diet. Medical comorbidities were present in 77%, with anemia (51%) and thyroid disease (28%) being the most common. Gynecological disorders were identified in 96% of women, predominantly adenomyosis (37%), leiomyoma (29%), and endometrial polyps (21%). Heavy menstrual flow was reported by 74%, while 67% had irregular bleeding and 67% had cycles shorter than 21 days. Regarding quality of life, 23% had poor, 51% moderate, and 26% good overall quality of life. The social relationship domain was most affected, with 35% reporting poor quality of life, followed by psychological health (25%). Poor quality of life was more frequently observed among women with anemia (32%), heavy menstrual flow (29%), mental stress (29%), adenomyosis (28%), leiomyoma (26%), and medical comorbidities (28%). Conclusion: AUB was associated with substantial multidimensional impairment in quality of life, particularly in social and psychological domains. Heavy bleeding, irregular menstruation, anemia, mental stress, adenomyosis, leiomyoma, and medical comorbidities were prominent associated factors. Comprehensive, patient-centered management addressing both the underlying gynecological causes and associated physical and psychosocial consequences is essential to improve the overall well-being of women with AUB.

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