Determination of total menstrual blood loss.
OBJECTIVE
To develop and validate a simple method of measuring total menstrual blood loss using a pictorial representation of blood loss, the menstrual pictogram.


METHODS
A prospective evaluation of total menstrual blood loss measurement by the menstrual pictogram compared to the alkaline hematin technique.


METHODS
Academic menorrhagia research clinic.


METHODS
One hundred twenty-one women; 62 women complaining of heavy menstrual blood loss, 59 women who considered their menstrual blood loss to be normal.


METHODS
Participants were asked to complete the menstrual pictogram through the period and collect their feminine hygiene products for an alkaline hematin assessment.


METHODS
Percentage agreement between blood loss measured by the gold standard alkaline hematin method and the menstrual pictogram. Extraneous blood loss was measured using a semiquantitative pictorial method.


RESULTS
The menstrual pictogram had a high level of agreement for blood collected on feminine hygiene products compared with the alkaline hematin method. Some women also lose a significantly large amount of extraneous blood, which is not proportional to the alkaline hematin blood loss assessment.


CONCLUSIONS
The menstrual pictogram provides a simple means of measuring menstrual blood loss. It is no longer appropriate to ignore extraneous blood loss, particularly as there is no correlation between extraneous blood loss and that measured on feminine hygiene products.
Wyatt
K M
KM
Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital, Stoke-on-Trent, United Kingdom.
Dimmock
P W
PW
Walker
T J
TJ
O'Brien
P M
PM
D000328:Adult; D005260:Female; D006176:Gynecology / Q000379:methods*; D006427:Hemin; D006801:Humans; D008595:Menorrhagia / Q000175:diagnosis / Q000503:physiopathology*; D052576:Menstrual Hygiene Products; D008598:Menstruation / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values
D006427:Hemin