# Gynaecological Morbidities and Treatment-Seeking Behaviour Among Post-menopausal Women in Kerala: A Cross-Sectional Study

## TL;DR

This study found that about 14% of postmenopausal women in Kerala experience gynaecological issues, but only two-thirds receive treatment despite seeking care.

## Contribution

The study provides new prevalence data and insights into treatment-seeking behavior for gynaecological morbidities among postmenopausal women in Kerala.

## Key findings

- The most common gynaecological issues were urogenital infections and benign genital tract disorders.
- Women with diabetes, thyroid disorders, or early menopause had higher odds of gynaecological morbidities.
- Although all affected women consulted healthcare providers, only 63.6% received treatment.

## Abstract

Background

Gynaecological morbidities (GMs), including pelvic organ prolapse, urogenital infections or inflammations, benign and malignant genital tract disorders, and postmenopausal bleeding, are significant but under-recognised health concerns among postmenopausal women. Limited data are available on their prevalence and treatment-seeking behaviour in Kerala. This study aimed to estimate the prevalence of GMs, identify associated factors, and assess treatment-seeking patterns.

Methods

A community-based cross-sectional study was conducted in Kannur and Ernakulam districts of Kerala, representing the northern and southern regions of the state. Using multi-stage cluster sampling, 384 postmenopausal women aged 45-69 years were selected from 24 clusters. Data were collected through a pre-tested, semi-structured interview schedule covering sociodemographic characteristics, self-reported GMs, and healthcare access. Descriptive statistics were used to estimate prevalence and treatment patterns, chi-square tests assessed associations, and multivariable logistic regression identified factors independently associated with GMs. Treatment-seeking was defined as consultation with a healthcare provider, while receipt of treatment indicated initiation of medical care.

Results

The prevalence of GMs was 14.1% (n = 54, 95% CI: 10.9-17.8). The most commonly reported conditions were urogenital infections or inflammations (5.0%), benign genital tract disorders (5.5%), pelvic organ prolapse (2.8%), malignant genital tract disorders (0.5%), and postmenopausal bleeding (0.3%). Higher odds of GMs were observed among women aged 45-59 years (adjusted odds ratio (AOR) = 2.13, 95% CI: 1.01-4.46), those with diabetes mellitus (AOR = 2.99, 95% CI: 1.44-6.21), thyroid disorders (AOR = 4.21, 95% CI: 2.08-8.52), and early menopause (AOR = 2.20, 95% CI: 1.15-4.21). All affected women sought consultation; however, only 63.6% received treatment. Most approached private hospitals (74.1%) and gynaecologists (66.7%).

Conclusion

Approximately one in seven postmenopausal women reported GMs. Despite universal consultation, treatment uptake was suboptimal. Strengthening public health services, increasing awareness, and addressing barriers to care are essential to improve outcomes for this population.