Menstrual Cycle Patterns among Adult Females Attending a Neuropsychiatric Facility in Kaduna, Northwestern Nigeria

Abstract

INTRODUCTION Menstruation is a very important aspect of any woman’s life. Changing levels of reproductive hormones during the menstrual cycle can impact the incidence and pattern of neuropsychiatric illnesses. However, little is known about the impact of neuropsychiatric illness on the menstrual cycle. Abnormal patterns of menstruation may cause difficulties in this set of patients, from issues related to hygiene, to missed comorbidities. This study aimed to study menstrual patterns and characteristics among patients with neuropsychiatric illness.

METHODOLOGY A cross-sectional study was conducted between November 1st 2022 to January 31st 2023. Participants were adult female patients diagnosed with neuropsychiatric illness. Data were collected using the Mini International Neuropsychiatric Interview, and a questionnaire with information on general socio-demographic characteristics, menstrual characteristics and possible confounding variables which may affect cycle regularity. Data were analysed using SPSS version 22, presented in frequency tables for descriptive purposes, and the relationship between categorical variables was analysed using chi-square or Likelihood ratio. A p-value of <0.05 was considered statistically significant.

RESULTS All 285 participants were aged 18 – 40 years. Majority were Hausa (179, 62.8%), Muslims (192, 67.4%), married (149, 52.3%), had secondary/post-secondary education (200, 70.2%) and unemployed (174, 61.1%). Most participants were parous (175, 61.4%), attained menarche normally between the ages of 10 and 16 (215, 75.4%). Eighty -one participants (28.4%) had normal cycle lengths, duration of menstrual flow was abnormal in majority (193, 67.7%), most had normal volume of menstrual flow (188, 66.0%), and dysmenorrhea (212, 74.4%) which was mostly mild. The commonest diagnosis was schizophrenia (131,46%), depressive disorders (55, 19.3%) and seizure disorders (40, 14.0%). Most participants’ duration of illness was 1 -5 years (132, 46.3%), and stable (129, 45.3%). There was no significant association between diagnosis and cycle length, duration of menstrual flow and menstrual pain (p-value >0.05). Volume of menstrual flow was associated with diagnosis (p-value <0.05).

CONCLUSION The duration of menstrual flow was abnormal in majority of participants. Those with seizure disorders appeared to have more abnormal volumes of menstrual flow, as compared to depressive disorders or schizophrenia. Carers should routinely screen for menstrual abnormalities.