Gynecological morbidity includes any condition, disease or dysfunction of the reproductive system which is not related to pregnancy, abortion or childbirth, but which may be related to sexual behaviour (Fortney, 1995). Systematic estimate of gynecological morbidity are not easily available. Our knowledge of gynecological morbidity is based on few studies in parts of the state and some studies in India. We first discuss the reproductive health of adolescent girls since they constitute a special subgroup among women in reproductive age. We then look at available information about gynecological problems reported by all women in reproductive age.

Reddy, Rani and others (2000) surveyed 274 adolescent school going girls in Tirupati town of Andhra Pradesh to study awareness and perception about menarche, and menstrual problems. 200 of the 232 post menarcheal girls reported 232 problems experienced before menstruation. Dysmenorrhoea (backache) was felt by 50% of the adolescents prior to as well as during menstruation. Bad odour of menstrual blood was the prominent problem reported by 57% of the adolescent girls. Profuse menstrual bleeding was complained by 31% of the adolescent girls. Calf muscle pain was the number one complaint felt prior to as well as during menstruation by more than a quarter of the adolescent girls. Tiredness was the number two problem experienced prior to the menstruation by 20.5% of the adolescent girls and this complaint had declined to 6% during menstruation. Irritability was third in rank reported by 20.5% adolescent girls before and 21.3% girls during menstruation.

Joseph, Bhattacharji (1997) studied adolescent girls problems in rural area of Tamil Nadu. Both qualitative and quantitative methods were used to elicit information. Three Focus group discussions revealed that menstrual irregularities were most prominent while a few complained of white discharge. Quantitative study of 190 adolescents showed that sleep disturbances, loss of weight, frequent headaches and dermatological problems were more common among those who attained menarche. While dysmenorrhoea and premenstrual tensions were very common, other menstrual problems also seemed frequent. Nearly one-fifth of all adolescents complained of white discharge.

Bhatia, Cleland and others (1997) studied gynecological morbidities among 385 women with young children residing in a district of Karnataka state. Gynecological morbidity was assessed from self reports, clinical examination and laboratory tests; Reproductive tract infections, emerged as the most common problem. The two common conditions, identified by laboratory test, were mucopurulent cervicitis (36.6%) and bacterial vaginosis (18.2%). Gynecological examinations revealed that 24% and 13% of the women had clinical signs of cervicitis and vaginitis respectively. Detailed menstrual history of the women taken by the gynecologist showed that more than half of the women reported painful menstruation (dysmenorrhoea). The contribution of sexually transmitted diseases to overall gynecological morbidity appears to be relatively modest; 10% were diagnosed.

Bang and others (Bang et al, 1989) in Gadchiroli district of Maharashtra examined gynecologic morbidity. Of 650 women who were studied, 55% had gynecological complaints and 45% were symptom free. 92% of all women were found to have one or more gynecological or sexual diseases, and the average number of these diseases per woman was 3.6. Table 1 shows the common gynecological and sexual complaints made by the women in Gadchiroli. Amenorrhoea, Dysmenorrhoea, Vaginal discharge and scanty periods were found to be very common. 

Parikh, Taskar et.al., (1989) studied levels, patterns and correlates of gynecological morbidity in an urban slum of Bombay, focusing on both women's perceptions and assessment of their gynecological health as well as the conclusions of medical assessments and laboratory tests. The sample comprised of 756 ever married women residing in a slum. Chlamydia was detected by laboratory test in 14% of 399 women, Trichomoniasis was observed among 10% of all women but STDs such as gonorrhoea (1.5%) and syphilis (0.3%) were rare. As many as 31% women reported one or more endogenous infections: Candidiasis was observed in 17% and bacterial vaginosis is observed in 15% of the women.

Patel and Khan (1996) surveyed 1790 women in a community in rural Uttar Pradesh to find out the levels of self-reported gynecological morbidities. Of those women reporting menstrual problems 33% had excessive bleeding, 20% had continuous bleeding for 10 days or more and 27% had occasional bleeding. It is also found that 31% of the women reported urinary problems.

The NFHS-2 collected information from women on some common symptoms of RTIs. 38% of ever-married women report at least one type of problem related to vaginal discharge, and 19% report symptoms of a urinary tract infection. Overall, 43% of women report either problems with vaginal discharge or symptoms of a urinary tract infection.

1. Abnormal vaginal discharge, caused mostly by bacterial vaginitis, cervicitis, or to some extent trichomoniosis.
2. Oligomenorrhoea (scanty periods), amenorrhoea, probably due to anaemia, under nutrition, tuberculosis or other pathology.
3. Urinary tract infections
4. Pelvic inflammatory diseases and sexually transmitted diseases.
5. Adolescent menstrual difficulties like back ache (Dysmenorrhoea), calf pain, irritability, etc.,.

                              Updated by Samatha Reddy Dated: 18/08/2003