Etiological Factors Associated With Abnormal Uterine Bleeding Among Adult Women Presenting to Tertiary Healthcare Settings.

BACKGROUND

Abnormal uterine bleeding (AUB) is a common gynecological condition affecting women of reproductive age and is associated with quality of life, physical well-being, and healthcare impact. AUB has varying etiologies classified as structural or non-structural, which influence clinical presentation and patient outcomes. The purpose of this study was to determine the prevalence of AUB etiological determinants in women of reproductive age and to evaluate the role of these sociodemographic factors affecting their prevalence.

METHODS

It is a cross-sectional observational study conducted over six months in a tertiary care hospital in Karachi. Non-probability consecutive sampling was used to recruit 171 women diagnosed with AUB and aged between 18 and 45 years. Clinical examination and transvaginal ultrasound were used to assess participants. Information on ages, body mass index (BMI), parity, educational level, socioeconomic status, and place of residence was collected.

RESULTS

The average age was 39.17 ± 5.24 years, and the BMI was 27.94 ± 5.96 kg/m. Leiomyoma was the most frequent etiological factor in 171 women (56.7%), followed by polyps (28.1%) and adenomyosis (10.5%). Infrequent cases were endometrial abnormalities (1.8%), iatrogenic (2.3%), and hyperplasia (0.6%). The structural causes were more prevalent among less-educated women and among women who lived in under-resourced regions. There were no definite associations with age, BMI, marital status, or parity. The mean duration of symptoms was 15.15 ± 11.68 months, which demonstrated the tendency of late clinical manifestation.

CONCLUSION

Leiomyomas and polyps were found to be the most common underlying causes of AUB among reproductive-age women, where structural factors were more prevalent among less well-educated women and patients with limited healthcare access.