Bridging Medical (FIGO 2018) and Islamic Perspectives in Defining Menstruation: A Comparative Study at Tertiary Hospital
- 1 Department of Obstetrics and Gynaecology, Kulliyyah of Medicine, International Islamic University Malaysia
Received 20 October 2026 · Accepted 26 October 2026 · Published 26 October 2026 · Corrected 9 November 2026
DOI: https://doi.org/10.5281/zenodo.23675639
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Abstract
Introduction
Menstruation represents a convergence of medical and religious implications in the lives of Muslim women. While FIGO 2018 defines normal and abnormal uterine bleeding (AUB) based on cycle length, duration, and volume, Islamic jurisprudence classifies menstruation through observable features such as blood colour, consistency, and prescribed durations. These differing frameworks often result in uncertainty for women attempting to determine their state of purity (Tahārah), especially in cases of irregular bleeding. This study aims to bridge the gap between medical science and Islamic rulings, offering evidence-based guidance that empowers Muslim women to navigate both health and religious obligations with confidence and clarity.
Materials and methods
A comparative cross-sectional study was conducted at the Obstetrics and Gynaecology Clinic of Hospital Sultan Haji Ahmad Shah (HoSHAS), Temerloh, involving 220 reproductive-aged women with either normal menstruation or AUB. Participants completed structured assessments, including sociodemographic profiling, menstrual history, and one-month menstrual calendars, alongside the use of standardised 32 cm sanitary pads to estimate blood volume. Menstrual patterns were analysed using FIGO 2018 criteria, while blood characteristics such as colour and consistency were compared with Islamic jurisprudential descriptions. Statistical analysis was performed using SPSS Version 29, with significance set at p < 0.05.
Results
Among the 220 women studied, 54.1% had normal menses and 45.9% were diagnosed with AUB. AUB was significantly associated with prolonged bleeding (>8 days), irregular cycles, heavier volume, and darker, clotted blood—features that overlap with Islamic descriptions of istiḥāḍah. Notably, 84.2% of AUB cases reported bleeding beyond 8 days, and 63.2% reported clotting blood. These patterns may cause discrepancies in classification between medical and Islamic frameworks. The fair agreement (k=0.386) between FIGO and Islamic definitions reflects their differing areas of concern.
Conclusion
While FIGO and Islamic frameworks share duration as a key criterion, their differing focus on physiological normalcy vs pathological concern leads to partial alignment in defining menstruation, thus highlighting the need to integrate both views for a holistic understanding of menstruation
Original poster
References
- 1. Munro, M. G., et al (2018). The FIGO classification of causes of abnormal uterine bleeding in the reproductive years (PALM–COEIN). Fertility and Sterility, 110(3), 393–398.
- 2. Ahmed, S., et al(2022). Menstruation and Islam: Medical and religious perspectives in modern contexts. Journal of Islamic Medical Ethics, 8(2), 175–190.
- 3. Hasim, N. A., et al. (2016). Haid daripada Perspektif Sains dan Maqasid Syariah. Sains Malaysiana, 45(12), 1879–1885.