The impact of gynecological morbidity on women's quality of life in northern Mexico.

Abstract

This study evaluates the burden of dysmenorrhea, dyspareunia, chronic pelvic pain and urinary incontinence on the quality of life of Mexican women. Recent discussions involving policy-makers and researchers highlight the urgency of developing a broader approach to addressing women's reproductive health needs and their connection with health policy priorities, especially in less developed nations. Despite advances made since the adoption of the concept of reproductive health in the 1990's, the organizing principle of current health policies and most research continues to be the prevalence of illness over health, a fact that reinforces a narrow conceptualization of women's health needs. As a result, the reproductive health agenda has focused on a restricted number of morbidity indicators, particularly those associated with life-threatening diseases. Due in part to this emphasis on life-threatening diseases, gynecological morbidities such as dysmenorrhea, dyspareunia, chronic pelvic pain and urinary incontinence have been neglected in research and service delivery programs targeting women. The burden of these gynecological morbidities on the quality of life of Mexican women was the focus of this cross-sectional population-based survey conducted among 1307 women aged 25-54 in Hermosillo, Mexico. Pelvic pain was a major gynecological complaint among women of reproductive age with 40% reporting dysmenorrhea, 12% dyspareunia and 6% chronic pelvic pain. Younger age increased the odds of these gynecological conditions. This study suggests a substantial overlap between genitourinary tract symptoms, gastrointestinal symptoms and pelvic pain. Urinary incontinence was reported by 18% of the study population. Parity, high body mass index, chronic urinary tract infections and having a history of hysterectomy or uterine leiomyomata were associated with increased odds of reporting incontinence. This research found that gynecological morbidities were associated with women reporting poor health-related quality of life (HRQOL) and having a negative health perception. Approximately 30% of the study population reported a single gynecological morbidity, while 16% reported two or more morbidities. Younger women were at higher risk of having concurrent gynecological morbidities which implied poor-HRQOL associated with depression, anxiety/fear, menstrual disturbance, sleep and sexual problems. Study finding have implications for the public health agenda.