"In the South Asian survey of 2,500+ women, 45% had heavy menstrual bleeding, linked to a 15% higher risk of depression. Nearly 30% screened positive, highlighting the need to integrate menstrual and mental health care," the researchers reported.
The research, led by Isabel Charles from the Hubert Department of Global Health, Rollins School of Public Health, Emory University, analyzed cross-sectional data from 3,438 adult women in Bangladesh and India. The team focused on 2,564 women who had menstruated within the past year, assessing the association between HMB and symptoms of depression.
HMB, defined clinically as menstrual blood loss that disrupts daily life—physically, emotionally, or socially—was assessed using the validated SAMANTA scale. Depression symptoms were measured through the CESD-10, a widely used depression screening tool.
The key findings were as follows:
- 45% of women reported experiencing heavy menstrual bleeding (HMB), with city-wise prevalence ranging from 41% to 46%.
- 30% of participants scored above the CESD-10 threshold, indicating symptoms of depression.
- Women with HMB had a 15% higher risk of screening positive for depression.
- HMB was associated with higher CESD-10 scores (β: 0.07).
- The strength of the association between HMB and depressive symptoms varied across cities.
- Certain urban sites exhibited a stronger link, indicating the need for location-specific interventions.
The authors emphasize the importance of recognizing HMB not only as a gynecological concern but also as a mental health issue. They advocate for the integration of menstrual health management and mental health support into routine reproductive healthcare services. By doing so, health systems in low- and middle-income countries can better support the holistic well-being of women.
The study contributes valuable evidence to a limited body of literature focused on the intersection of menstrual and mental health in South Asia. It calls for further investigation into the biological and social mechanisms linking HMB with depression. It encourages the development of targeted interventions to address the needs of women suffering from both conditions.
The authors concluded, "The findings are particularly relevant for policymakers, healthcare providers, and public health advocates aiming to improve women's health outcomes in the region. Addressing HMB comprehensively could play a crucial role in reducing the mental health burden among menstruating women, especially in underserved communities."
Reference:
Charles, I., Patrick, M., Mink, T., Ahmed, T., Reddy, Y. M., Young, M. R., Waford, R., Caruso, B. A., & Sinharoy, S. S. (2025). Association Between Heavy Menstrual Bleeding and Depression Among Women in South Asia: A Cross-Sectional Study. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.06.018
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