Perceptions and treatment seeking for abnormal uterine bleeding among women of reproductive age group in rural North India: a qualitative study

Abnormal uterine bleeding (AUB), affecting 3–30% of women of reproductive age, can lead to serious physical complications such as anaemia and infertility, and also negatively impacts mental well-being, social participation, and economic productivity. Despite this, treatment-seeking remains low due to poor health literacy, cultural taboos, limited autonomy in decision-making, and inadequate access to female healthcare providers. The qualitative study was conducted between September—November 2022 in Sahupura Village, under Primary Health Centre (PHC) Dayalpur, Faridabad, Haryana, using in-depth interviews (IDIs) and focused group discussions (FGDs) with various stakeholders, including WRA, accredited social health activists (ASHA), multipurpose health workers (MPW), and gynaecologists. Nine IDIs and four FGDs were conducted including a total of 38 participants. Thematic analysis was done to analyse both IDIs and FGDs. Four key domains were identified: perceptions about AUB, treatment-seeking behaviour, perceived impact, and barriers to seeking treatment. According to WRA, AUB was characterized by changes in the frequency, duration, amount, and quality of menstrual bleeding. Women of reproductive age (WRA) had varied perceptions of AUB, often influenced by cultural beliefs and misinformation. Treatment-seeking behaviour was commonly delayed due to normalization of symptoms, lack of awareness, and social stigma. The perceived impact of AUB extended beyond physical health, affecting mental and social well-being, with implications for daily functioning. Barriers hindering seeking treatment included limited availability of female doctors, long queues in hospitals, high travel costs, lack of support from family, and a fear of potential side effects of drugs. The study highlights that women’s treatment-seeking for abnormal uterine bleeding (AUB) is dependent not only on their understanding of the condition but also on sociocultural stigma, limited autonomy, and the preference for female healthcare providers. Addressing these individual and systemic barriers is essential to improving access to timely and appropriate care for AUB.