Bridging Medical (FIGO 2018) and Islamic Perspectives in Defining Menstruation: A Comparative Study at Tertiary Hospital

Introduction. Menstruation represents a convergence of medical and religious implications in the lives of Muslim women. While FIGO 2018 defines normal and abnormal uterine bleeding (AUB) based on cycle length, duration, and volume, Islamic jurisprudence classifies menstruation through observable features such as blood colour, consistency, and prescribed durations. These differing frameworks often result in uncertainty for women attempting to determine their state of purity (Tahārah), especially in cases of irregular bleeding. This study aims to bridge the gap between medical science and Islamic rulings, offering evidence-based guidance that empowers Muslim women to navigate both health and religious obligations with confidence and clarity. Materials and methods. A comparative cross-sectional study was conducted at the Obstetrics and Gynaecology Clinic of Hospital Sultan Haji Ahmad Shah (HoSHAS), Temerloh, involving 220 reproductive-aged women with either normal menstruation or AUB. Participants completed structured assessments, including sociodemographic profiling, menstrual history, and one-month menstrual calendars, alongside the use of standardised 32 cm sanitary pads to estimate blood volume. Menstrual patterns were analysed using FIGO 2018 criteria, while blood characteristics such as colour and consistency were compared with Islamic jurisprudential descriptions. Statistical analysis was performed using SPSS Version 29, with significance set at p < 0.05. Results. Among the 220 women studied, 54.1% had normal menses and 45.9% were diagnosed with AUB. AUB was significantly associated with prolonged bleeding (>8 days), irregular cycles, heavier volume, and darker, clotted blood—features that overlap with Islamic descriptions of istiḥāḍah. Notably, 84.2% of AUB cases reported bleeding beyond 8 days, and 63.2% reported clotting blood. These patterns may cause discrepancies in classification between medical and Islamic frameworks. The fair agreement (k=0.386) between FIGO and Islamic definitions reflects their differing areas of concern. Conclusion. While FIGO and Islamic frameworks share duration as a key criterion, their differing focus on physiological normalcy vs pathological concern leads to partial alignment in defining menstruation, thus highlighting the need to integrate both views for a holistic understanding of menstruation Key messages. Bridging the gap between medical science and Islamic rulings in defining menstruation, the fair agreement (k=0.386) between FIGO and Islamic definitions reflects their differing areas of concern Menstrual patterns were analysed using FIGO 2018 criteria, while blood characteristics such as colour and consistency were compared with Islamic jurisprudential descriptions. the need for integrated, faith-sensitive healthcare approaches that align FIGO criteria with Islamic rulings, enabling Muslim women to determine their menstrual status with greater clarity.