The Impact of Abnormal Uterine Bleeding on Adolescents' Quality of Life: Results of the Adolescent Menstrual Bleeding Questionnaire.

Abstract

Objective: To determine the extent to which abnormal uterine bleeding affects the quality of life in adolescents.

Materials and methods: The study included a total of 69 patients who presented to our clinic with menstrual bleeding lasting more than 7 days, occurring more frequently than every 21 days, and showing signs of increased blood loss within a cycle. Following the collection of detailed medical histories and physical examinations, initial diagnostic tests were performed, including a complete blood count, coagulation tests (prothrombin time, activated partial thromboplastin time, and fibrinogen), and iron parameters (serum iron, ferritin, and total iron-binding capacity). After obtaining informed consent, adolescents who presented to general pediatrics, pediatric endocrinology, and pediatric hematology clinics with complaints of abnormal uterine bleeding were asked to complete the Adolescent Menstrual Bleeding Questionnaire.

Results: The mean age of the 69 patients included in the study was 14.95 years (range: 11-18), and the mean age at menarche was 12.2 years (range: 9-16). Of the patients, 28.9% (n = 20) had been admitted to the hospital for the first time due to bleeding, and 71.1% (n = 49) had been admitted before and had used some treatments. During menstruation, 23.2% (n = 16) of the patients reported severe pain, 43.5% (n = 30) reported moderate pain, and 18.8% (n = 13) reported mild pain. School absenteeism was observed in 36.2% (n = 25) of the patients. Additionally, 63.8% (n = 44) of the patients reported avoiding at least 1 day of family-related activities (such as household chores or shopping). The mean questionnaire score for patients with heavy bleeding was 33.9 ± 1.6, while those with light to moderate bleeding had a mean score of 27 ± 1.8 (p = 0.005). As a result, 47.8% (n = 33) of the patients scored below 30, and 52.2% (n = 36) scored above 30. When patients scoring above and below 30 were compared, the need for adult diaper use, incidence of bleeding through outer clothing, school absenteeism, and level of activity avoidance were significantly higher in those scoring above 30. The highest score was observed in patients who had never received treatment [35.5 (±11.6) (11-61)] and the lowest score was observed in patients receiving iron and combined oral contraceptive pills (OCPs) treatment [28.6 (± 10.06) (10-44)] (p = 0.058) Anxiety levels were rated at 10 points by 36.2% (n = 25) of the patients. The mean anxiety score of patients with an aMBQ score > 30 was 8.64 ± 2, and that of those with an aMBQ score < 30 was 5.55 ± 3.36 (p = 0.000). The mean hemoglobin level of the patients was 12.4 g/dL (range: 5.7-16). Fibrinogen, PT, and aPTT levels were within normal ranges.

Conclusion: Abnormal uterine bleeding is not merely a physical issue but a public health concern that profoundly impacts the social and emotional lives of adolescent girls. A comprehensive approach is key to improving adolescents' quality of life.