Heavy Menstrual Bleeding for Women Approaching or in Perimenopause in Rural Uganda

Background: While heavy menstrual bleeding (HMB) is one of the most common gynecological complaints in women, research on the impact of heavy menstrual bleeding is limited in low-middle income countries (LMICs). The goal of this study is to understand the experiences of women approaching or in perimenopause who endure HMB in rural Uganda.

Methods: Data from this cross-sectional study was collected as part of a larger cervical cancer screening study from May 2024 to October 2025 in rural Uganda. Women were eligible if they participated in the cervical cancer screening study and had menstruated in the past year. Participants were recruited door-to-door by village health teams. Participants completed an electronically administered baseline and endline survey about their demographics and menstrual health. Women were categorized as either HMB or light-moderate menstrual bleeding (LMMB). Counts and frequencies were reported.

Results: There were 121 women who reported having HMB, and 371 women LMMB. HMB participants were more likely to experience irregular and painful periods (p<0.001). They were also more likely to report that their period prevented them from carrying out work outside of the home (n=48, 39.7% HMB; n=50, 13.5% LMMB; p<0.001) and caring for their children (n=33, 27.3% HMB; n=37, 10% LMMB; p<0.001). Both groups reported a high level of comfort in seeking menstrual help r from a healthcare provider (n=117, 97.5% HMB; n=353, 95.4% LMMB; p=458). Finances were the biggest barrier for all participants in seeking help from a care provider.

Interpretation: There is a need for more research on the impact of menstruation on women in Uganda and similar LMICs. By better understanding the direct and indirect consequences of menstruation, we can develop practical support systems and policies for those impacted.