Factors affecting health-related quality of life in women with and without abnormal uterine bleeding: an unmatched case-control study

Abnormal uterine bleeding (AUB) represents one of the most prevalent indications for outpatient consultations among women of reproductive age. The present investigation sought to assess the health-related quality of life and its determinants, encompassing sexual quality of life and sexual distress, among women afflicted with and without AUB. Employing an unmatched case-control design with a 1:2 allocation ratio, including 282 cases and 141 controls. Enrollment proceeded through a convenience sampling method. Instruments for data acquisition comprised demographic-obstetric, health-related QoL, the sexual quality of life, and the sexual distress questionnaires, administered via self-report protocols. Comparative analyses demonstrated that the mean score of health-related QoL was markedly elevated in the control group relative to the case group [69.45 (7.75) versus 56.26 (16.82); P < 0.001]. Concordantly, the composite sexual quality of life score exhibited a significant augmentation in controls compared to cases [78.10 (15.02) versus 73.18 (17.23); P < 0.001]. Conversely, the mean sexual distress score was substantially heightened among women with AUB vis-à-vis controls [27.80 (10.31) versus 25.20 (7.82); P = 0.004]. Multiple linear regression analysis identified five salient predictors of health-related QoL: sexual distress, sexual QoL, menstrual status, age, and educational attainment. Notably, menstrual status and sexual distress conferred the most pronounced influences; absence of AUB (P < 0.001, β = 0.275) presaged enhanced QoL, whereas escalating sexual distress (P = 0.033, β = -0.227) portended diminution thereof. In summation, AUB appears to have a significant impact on various aspects of women's general and sexual quality of life. Sexual distress is notably higher in women with abnormal bleeding, which in turn affects their overall and sexual well-being. Given that the quality of life among women of childbearing age can influence the long-term health of family members, greater attention is warranted to addressing sexual health issues that may negatively impact women's quality of life. This requires the attention of healthcare providers, midwives, family counselors, and psychologists.