Abnormal uterine bleeding, menstrual poverty and the financial burden of menstrual hygiene among Brazilian adolescents: A multicenter cross-sectional study on health inequities.

OBJECTIVE

To describe menstrual period characteristics among Brazilian adolescents, focusing on menstrual patterns, use of sanitary products, and influence of socioeconomic conditions on menstrual health.

METHODS

A multicenter cross-sectional study was conducted, including adolescents from all official sociodemographic regions of Brazil. The study evaluated menstrual cycle characteristics, usage patterns of menstrual products, and socioeconomic status (categorized A-E). There was also an analysis of the cost of sanitary pads and the resulting economic impact of these on household income.

RESULTS

A total of 195 adolescents were included (mean age: 16.70 ± 1.99 years), with 20.51% reporting self-perceived abnormal uterine bleeding (AUB). Among those with AUB, 60% had irregular cycles and 30% reported bleeding duration exceeding eight days. Compared to those with normal bleeding, adolescents with AUB used significantly more menstrual products (p < 0.001), reported more intermenstrual bleeding (p = 0.001), and required frequent changes of underwear (p = 0.005), clothing (p = 0.006), and bedding (p = 0.005). Among those with AUB, 52.5% resided in the poorest regions (North/Northeast) and identified as Black or mixed-race (brown-skinned), facing greater barriers to healthcare. The number of pad/cycles was higher in the AUB-group (p = 0.015). The financial burden was substantial: participants from higher socioeconomic strata (A-B2) allocated only 0.05%-0.15% of their income to pads, whereas this proportion was nearly 20 times higher for groups D-E (1.66%).

CONCLUSION

Brazilian adolescents exhibit a high prevalence of AUB, which correlates with increased hygiene product needs and a disproportionate financial burden. Addressing the link between socioeconomic inequity and period poverty is essential for public health.