Busitema University, in partnership with local and international collaborators, has embarked on a two-year study to determine how much blood girls lose during a single menstrual cycle. The research aims to develop practical tools to prevent excessive bleeding and reduce the risk of severe anaemia among Ugandan students.
Speaking at the launch of the project dubbed Vital Heavy Menstrual Bleeding (Vital-HMB) held in Kampala, Dr Milton Musaba, the head of Obstetrics and Gynaecology at Busitema University, said the study would begin in November and involve 5,000 girls from selected secondary schools, universities, tertiary institutions, hospitals, and communities across Uganda.
Dr Musaba, who is also the principal investigator for the project, said they hope to identify those who need specific targeted treatment, to avoid receiving them in hospital when they are very sick to the point of requiring blood transfusion.
‘We are going to collect all the pads the girls have used over a menstrual cycle, take them to the laboratory and be able to measure exactly how much blood is lost,’ Dr Musaba said.
‘We shall be able to quantify those with heavy menstrual bleeding and establish tools that can catch these girls early.’ He added: ‘Menstruation is an important signal of good health, but many times, we normalise the abnormalities and we don’t take care of abnormal periods that are painful or heavy because they have been normalised culturally, and when we do that, we miss an important underlying pathology.’
He explained that during the study, the girls will be taken through a number of tests to identify the cause of heavy bleeding. Dr Musaba said heavy menstrual bleeding occurs when girls or women of reproductive age lose more than 80 millilitres of blood per cycle-roughly equivalent to three teaspoons. He said current estimates suggest that one in three girls of reproductive age experiences heavy menstrual bleeding, a condition that affects both their health and education.
Busitema University’s David Mukunya, who is co-investigator for the Vital-HMB project, said heavy menstrual bleeding leads to severe anaemia and fatigue, which disrupts daily activities and class participation, forcing some learners to drop out of school. ‘Menstrual health has been a taboo topic because it has been labelled culturally inappropriate and school girls are suffering in silence.
They are moving around with headache, confusion, dizziness, and they are not productive in school,’ Prof Mukunya said. ‘You see a girl who is giving you a blank stare, and you probably think they are not interested in school, but they are dealing with a big hidden issue. We want to bring such issues to the surface.’
During the launch of the project, Dr Richard Mugahi, Commissioner for Reproductive, Maternal and Child Health in the Ministry of Health, acknowledged that heavy menstrual bleeding is an area that had been neglected for some time. Dr Mugahi also tasked researchers to address the myths that surround dysmenorrhea (painful periods) to prevent unwanted pregnancies.
‘When we were in a medical school, we used to hear people say when a young woman has excessive cramps, one of the treatments was getting pregnant,’ Dr Mugahi told researchers.
‘This belief has not changed, but is a very important concept of how science interacts with social norms, social beliefs. I hope you are going to pick something on dysmenorrhea.’