title: Determination of total menstrual blood loss.
abstract: 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.
authors: Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital, Stoke-on-Trent, United Kingdom.
authors: K M
authors: KM
authors: Wyatt
authors: P W
authors: PW
authors: Dimmock
authors: T J
authors: TJ
authors: Walker
authors: P M
authors: PM
authors: O'Brien
mesh_terms: 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
chemical_list: D006427:Hemin