Assessment of Causes and Clinical Symptoms of Menorrhagia and Its Co-relation with BMI in Western Nepalese Women - An Observational Study

Abstract

Background: Menorrhagia is defined subjectively as heavy menses lasting for more than 7 days or objectively as a mean menstrual blood loss of >80 ml during three consecutive menses. It can occur due to organic causes like fibroids, polyps, cervitis, ovarian cysts, adnexal masses, uterine cancer or systemic causes like hypothyroidism, bleeding disorders, pregnancy and prolapse or dysfunctional uterine bleeding. Body Mass Index may have a correlation with menorrhagia. Aim and Objectives: This study was carried out in western Nepalese women to assess the causes of menorrhagia; report most common symptoms associated with it and assess the correlation of causes of menorrhagia with BMI. Material and Methods: A hospital based observational study was carried out between 1st January 2015 to 31st January 2016 on 157 volunteer women who consulted the Department of Gynaecology and Obstetrics for menorrhagia. Data were collected via interview and with the help of a questionnaire. Height and weight of the patients were recorded for calculation of BMI. The data was analysed with SPSS 17 vesion. Mean,Standard Deviation and Chi-square test were applied and p value <0.05 was considered to be statistically significant. Results: In our study, maximum patients were from the age group of 36-40 years (51 {32.48%}) followed by 31-35 years (38 {24.2%}) whereas the least number of patients (6 {3.8%}) belonged to the age group of 51-55 years. Uterine fibroids was the most common etiology for menorrhagia seen in 76 (48.4%) patients with maximum cases (24 {31.6%}) being in 36-40 years age group and minimum (4 {5.3%}) in 51-55 years age group. Dysfunctional uterine bleeding (24{15.3%}) was the second most common etiology with 6 (25%) cases being in 31-35 years age group. No statistically significant association was observed between BMI and etiology of menorrhagia. Backache, abdominal distension, pain abdomen, breast pain, headache, weakness and pelvic pressure were the seven most common symptoms experienced by patients with menorrhagia. All the seven symptoms showed statistically significant association with menorrhagia (p<0.05). Conclusion: Menorrhagia is most prevalent among the age group of 31-35 and 36-40 years with uterine fibroids and dysfunctional uterine bleeding being the most common etiologic factors. There seems to be no clear association of menorrhagia with BMI. It is significantly associated with common symptoms like backache, abdominal pain, breast pain, weakness, abdominal distension, pelvic pressure and headache which considerably affect the quality of life of patients