Every month, a woman somewhere in Kenya cancels her plans, misses work, or stays home from school. She does not do this out of laziness; she does it because her period will not let her live normally.
She soaks through sanitary pads in less than an hour, passes clots the size of her fist, and bleeds for weeks without stopping.
Yet, when she mentions it, the response from a mother, a neighbour, or even a nurse is almost always the same: “That is just how it is for some women.”
It is not. And we need to stop pretending it is.
Abnormal Uterine Bleeding (AUB), which includes heavy, prolonged, or irregular bleeding, is one of the most common yet deeply ignored health crises affecting women today.
Statistically, one in every three women will experience AUB within their lifetime. Most suffer in silence because society has conditioned them to believe that debilitating pain and daily disruption are simply part of the tax of being a woman.
The physical harm is severe. Heavy menstrual bleeding is the leading cause of anaemia in women of reproductive age. When a woman bleeds excessively every month, her body slowly runs out of iron, leaving her chronically tired, weak, and unable to concentrate.
In vulnerable communities where nutrition is insecure and malaria is endemic, this level of chronic blood loss is dangerous and can be deadly if she later becomes pregnant.
But the damage is not only physical; the socio-economic losses compound over a lifetime. When a girl misses school every month, she falls behind her male peers.
When a woman cannot go to the market or sit through a business meeting without the paralysing fear of bleeding through her clothes, her confidence and her income suffer. These are not small inconveniences. They are systemic barriers to human and economic development.
In many communities across Kenya, menstruation remains shrouded in privacy, shame, and misunderstanding. Girls are rarely taught what a healthy period actually looks like, leaving them with no baseline to recognise when something is wrong.
By the time many women finally reach a health facility, they have endured the condition for years and are already severely anaemic.
This silence is not "culture." It is a systemic gap we have failed to close.
When a woman tells her doctor she bleeds heavily, she must be taken seriously, not patronised and sent home with painkillers. When a girl misses school every month, her teacher should ask questions, not just mark her absent. When a mother notices her daughter going through three pads in an hour, she must know it is a medical red flag, not a sign of weakness.
The tragedy is that AUB is not a life sentence. Most causes can be easily identified and managed. Simple, affordable medicines exist that significantly reduce heavy bleeding.
Hormonal options, including specific contraceptive devices, are highly effective, and minor procedures can resolve complex cases entirely. The obstacle is not a lack of medical treatments; it is a lack of institutional recognition.
To dismantle this silent epidemic, we must implement three immediate shifts:
1. First, we must democratise menstrual literacy. Women and girls need to know that bleeding through a pad every hour, passing large clots, or bleeding for more than seven days are clinical symptoms requiring medical attention, not endurance.
2. Second, we must equip our frontline health workers. From Community Health Promoters (CHPs) to nurses and clinical officers, health workers at every level need the training to ask the right questions, spot the signs of AUB early, and connect women to targeted care.
3. Third, our health systems must start counting this crisis. What is not measured cannot be managed. If the Ministry of Health does not track how many women are incapacitated by AUB, it will remain an invisible drain on our national productivity.
Abnormal uterine bleeding is a treatable medical condition, not an inescapable destiny. We have told women to endure for long enough. It is time the health system listened, measured, and acted.
As Kenya advances Universal Health Coverage and strengthens primary healthcare, AUB can no longer remain invisible. Recognising, measuring, and treating it must become a national reproductive health priority not only to safeguard women's health, but to protect our education, productivity, and economic progress.
By Felix Otieno, Senior Research Officer, International Centre for Reproductive Health – Kenya
