ArticleThe Lancet. Global health2023
Prevalence of heavy menstrual bleeding and associations with physical health and wellbeing in low-income and middle-income countries: a multinational cross-sectional study.
Article in The Lancet. Global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07188259 (Prevalence and Impact of Heavy Menstrual Bleeding Among Female Students in Assiut University, Egypt), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevalence and Impact of Heavy Menstrual Bleeding Among Female Students in Assiut University, Egypt
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Interdisciplinary management of gynecologic bleeding with anticoagulation: a recommended toolkit from the Foundation for Women and Girls with Blood Disorders+ Thrombosis Subcommittee.Journal of thrombosis and haemostasis : JTH · 2025Guideline
- The Impact of Heavy Menstrual Bleeding on Quality of Life: A Mixed-Methods Survey Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Call to action: identifying an underlying bleeding disorder in adolescents with heavy menstrual bleeding.Research and practice in thrombosis and haemostasis · 2026Review
- Review
- Spatial transcriptomics uncovers the hybrid molecular identity, ciliated phenotype, and immune signature of adenomyosis lesions.Science advances · 2026Article
- Anemia Secondary to Abnormal Uterine Bleeding Requiring Blood Transfusion in the Reproductive Age Group-A Retrospective Study.Life (Basel, Switzerland) · 2026Article
- Leveraging connections between family planning and nutrition to improve the health of women.BMJ global health · 2026Review
- Factors associated with hysterectomy after failure of levonorgestrel-releasing intrauterine system treatment in women with abnormal uterine bleeding.BMC women's health · 2026Article
- Is oral iron cheaper? Not if you count all the costs.Blood advances · 2026Article
- Cost-effectiveness of first-line IV vs oral iron for iron-deficiency anemia in women with heavy menstrual bleeding.Blood advances · 2026Article
- Article
- Current gynaecological management of women and girls with bleeding disorders in the United Kingdom: A UKHCDO haemophilia treatment centre survey and evaluation of real-world clinical practice for the British Journal of Haematology.British journal of haematology · 2026Article
- The effect of heavy menstrual bleeding on sexual quality of life: a case-control study.Revista da Escola de Enfermagem da U S P · 2026Article
- A scoping review on heavy menstrual bleeding and anemia: A less explored phenomenon.Journal of family medicine and primary care · 2026Review
- The Burden of Poor Reproductive Health in England: Results From a Cross-Sectional Survey.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Article
- The prevalence and burden of heavy menstrual bleeding, and market access barriers of medical interventions with a focus on low- and middle-income countries: a scoping review.BMC women's health · 2025Article
- Heavy menstrual bleeding and association with menstruation-specific resources: A multinational cross-sectional study in low- and middle-income countries.Health & place · 2025Article
- The association between various menstrual disorders and well-being was mediated by anxiety: a cross-sectional study.BMC women's health · 2025Article
- The Impact of Gynecological Pathologies on Patients' Quality of Life from Menarche to Menopause-Literature Review.Journal of clinical medicine · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundData 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.
methodsBetween 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.
findings4828 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).
interpretationHeavy 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.
fundingBill & Melinda Gates Foundation, United States Agency for International Development, National Institutes of Health.
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