Epidemiology of menstrual disorders in developing countries: a systematic review.

In developing countries, priority setting in the health sector traditionally focuses on the principal causes of mortality.More recently, the Global Burden of Disease approach incorporates assessment of morbidity and quality of life in identifying priorities. Yet, although investigations in various developing countries reveal that women are concerned by menstrual disorders, little attention is paid to understanding or ameliorating women’s menstrual complaints. Menstrual dysfunction, like other aspects of sexual and reproductive health, is not included in the Global Burden of Disease estimates and, even as reproductive health programs expand their focus to address gynaecologic morbidity, the utility of evaluating and treating menstrual problems is not generally considered. Available data from developing countries on the frequency of menstrual disorders and their impact on women’s health status, quality of life and social integration suggest that evaluation and treatment of menstrual complaints should be given a higher priority in primary care programs. This article reviews the literature on the prevalence of menstrual morbidity in developing countries and suggests a strategy for improving the quality of services provided to women with menstrual complaints.