Survey Shows Poor Reproductive Health Is a Growing Concern

TOPLINE:

A study highlighted significant disparities in reproductive health outcomes on the basis of age, ethnicity, and financial security among women in England.

METHODOLOGY:

• This cross-sectional survey aimed to quantify the burden of reproductive health on ethnic/financial disparities affecting women and people assigned female at birth aged 16-55 years.
• A total of 59,332 participants were recruited via a targeted online sampling strategy (September to October 2023), weighted for Census 2021 age distribution.
• Overall, 13 self-reported indicators of reproductive health were assessed across three domains: Reproductive morbidities (polycystic ovary syndrome or fibroids), menstrual health (dysmenorrhoea or menopause), and pregnancy-related adversities (loss or infertility).
• Data were stratified on the basis of age, ethnicity (UK Census categories), and financial security (questionnaire). Unplanned pregnancies were measured using a London Measure (score 0-3).
• The outcome measured was the proportion of participants reporting having issues related to various reproductive health indicators.

TAKEAWAY:

• Reproductive health issues affected 73.7% of participants, of whom 61.9% reported menstrual problems and 5.5% reported pregnancy-related complications.
• Morbidities included polycystic ovary syndrome (10.5%) and endometriosis (8.8%), followed by uterine fibroids, pelvic organ prolapse, and reproductive cancers.
• Black women had significantly higher risks for fibroids (adjusted odds ratio [aOR], 1.69), severely painful periods (aOR, 1.28), and pregnancy-related complications (aOR, 1.50).
• Financial stress was associated with poor reproductive health, indicating an increased risk for unplanned pregnancy (aOR, 4.96).
• Overall, severe period pain affected 18.7% of participants, peaking among adolescents and young adults (36.5% at 16-19 years; 32% at 20-24 years).

IN PRACTICE:

“Investment and innovation in health services and support strategies are urgently needed to mitigate the impact of poor reproductive health on the lives of women and those assigned female at birth,” the authors wrote.

SOURCE:

This study was led by Melissa J. Palmer, Department of Public Health, Environments, and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. It was published online on March 24, 2025, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

This study was limited by potential selection bias from underrepresentation of Black, Asian, minority ethnic groups, and less educated populations, exclusion of important reproductive health outcomes like birth trauma and menopausal cognitive symptoms, and reliance on self-reported National Health Service fertility treatment data, which may have missed private cases.

DISCLOSURES:

This study was funded by the Department of Health and Social Care. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.