Pattern of Abnormal Uterine Bleeding among Perimenopausal Women in Erbil City

Abstract

Background: Abnormal uterine bleeding (AUB) is an epidemic, painful condition among perimenopausal women and an indicator of the quality of life with reproductive health problems. The pattern and precipitating factors should be defined to guide early diagnosis and treatment. The objective of this study was to determine the pattern of abnormal uterine bleeding and precipitating demographic and clinical factors among perimenopausal women in Erbil city based on the FIGO PALM-COEIN classification system. Methods: In this cross-sectional study, Four hundred perimenopausal women aged between forty and fifty five years old, attending gynecology clinics in Erbil, were investigated. The data were collected with structured interviews and clinical examination. The etiologies of AUB were divided according to the PALM-COEIN classification. Statistical tests applied were chi-square tests and multinomial logistic regression to detect associations between patterns of bleeding and some variables. Results: Mixed bleeding (23.3%) was the most prevalent AUB type, followed by metrorrhagia (20.8%) and polymenorrhea (12.0%). Based on the FIGO classification, endometrial disorders (36.5%), leiomyomas (24.0%), and ovulatory dysfunction (16.0%) were the main etiologies. Bleeding patterns had no significant correlations with factors like age, BMI, marital status, education level, parity, gravidity, and use of contraceptives (p < 0.05). Multinomial logistic regression determined BMI, gravidity, and use of IUD as independent predictors of bleeding type. Conclusion: Perimenopausal women of Erbil with abnormal uterine bleeding are controlled by various reproductive and sociodemographic factors. Early diagnosis and standardized evaluation according to FIGO criteria are the keys to proper management and prevention of the gynecological disease burden.