Prevalence of Abnormal Uterine Bleeding and its Sub-types among Adolescent Girls in India: A Systematic Review and Meta-Analysis
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Objective
This study aimed to determine the national pooled prevalence of AUB, its sub-types, and dysmenorrhea among adolescent girls in India
Methods
We conducted a systematic review and meta-analysis following PRISMA guidelines, searching PubMed, Embase, and Web of Science from inception to December 4, 2024. Thirty-one observational studies involving adolescent girls aged 10-19 years with sample size ranging from 127 to 2000, conducted across India, were included. Due to high heterogeneity, pooled prevalence estimates were calculated using random-effects models.
Results
The pooled prevalence of AUB was 19% (95% CI: 15.0–22.0%). Pooled prevalence for the most common AUB sub-types noted are - oligomenorrhea (25%), metrorrhagia (24%), and menorrhagia (18%). Additionally, the pooled prevalence of dysmenorrhea was notably high, 53% (95% CI: 43–62%). Significant heterogeneity (I² > 90%) and regional disparities in prevalence were also observed in this review.
Conclusion
High prevalence of AUB (19 %) and its sub-types highlights the urgent need for the development of a standardised screening tool to be used among adolescent girls in schools and the community, and also the integration of screening programs in adolescent reproductive and sexual health clinics to combat long-term health burden
What is already known on this subject?
It has been previously established that abnormal uterine bleeding (AUB) and dysmenorrhea are serious gynecological issues in adolescent females worldwide, with studies indicating a variable prevalence. In India, several individual studies and regional reviews have shown the prevalence of various menstruation disorders, emphasizing concerns like oligomenorrhea related to PCOS and the high incidence of dysmenorrhea. These studies have consistently identified cultural stigma, lack of awareness, and diagnostic delays as significant impediments to effective care. The current literature is fragmented, exhibiting significant methodological variability, regional biases, and an absence of a unified national estimate, complicating the assessment of the overall burden of AUB and its specific subtypes among India’s adolescent population
What this study adds?
This systematic review and meta-analysis provide the inaugural comprehensive, national-level pooled prevalence estimates for AUB and its distinct subtypes solely among adolescent females in India. By combining data from 31 studies in different parts of India, we find that almost one-fifth (19%) of Indian teens have AUB. The most prevalent kinds are oligomenorrhea (25%) and metrorrhagia (24%), while more than half (53%) have dysmenorrhea. This study transcends narrative synthesis to provide substantial, quantitative evidence of pronounced regional differences and the considerable variation arising from diverse diagnosis criteria. Our findings highlight the essential public health necessity for the creation of standardized screening instruments and the incorporation of targeted interventions into school and community health initiatives to alleviate the enduring repercussions of these widespread illnesses.
