Cultural Beliefs and Delayed Health-Seeking Behavior in Women with Abnormal Uterine Bleeding

Abstract

Background: Abnormal uterine bleeding (AUB) is a common gynecological condition affecting reproductive-aged women, often leading to delayed health-seeking due to cultural stigma and normalization of symptoms in conservative settings like urban Pakistan. Objective: To determine the prevalence of AUB and identify sociocultural factors associated with delayed health-seeking behavior among women attending gynecology clinics in Pakistan. Methods: This cross-sectional observational study enrolled 450 reproductive-aged women from outpatient gynecology clinics in Karachi and Lahore using consecutive sampling. Data were collected via structured interviews incorporating FIGO criteria for AUB assessment and modules on health-seeking and cultural beliefs. Descriptive statistics, chi-square tests, and multivariable logistic regression were performed to examine associations. Results: The prevalence of AUB was 32.4% (142/438), with 68.3% of affected women reporting delays >6 months in seeking care. Lower education, cultural normalization, high stigma, and reliance on traditional advice were significantly associated with delays (adjusted odds ratios >2, p<0.05), explaining substantial variance alongside socioeconomic factors. Conclusion: Sociocultural barriers significantly contribute to delayed care for AUB, necessitating culturally sensitive education and community interventions to promote timely utilization and reduce morbidity.