title: Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data.
abstract: OBJECTIVE
  Menorrhagia is defined as blood loss of >80 mL, but in routine clinical practice measurement is seldom undertaken. Our aim was to identify the features of the clinical history that best predict menorrhagic blood loss.
  
  
  METHODS
  A questionnaire survey of 952 menstrual complaint referrals at 3 hospital gynecology clinics in Glasgow and Edinburgh included 226 women with putatively heavy periods who also had consented to the measurement of their blood loss.
  
  
  RESULTS
  Only 34% (95% CI, 28%-40%) of women had blood loss volume of >80 mL, but the volume was associated with subjective heaviness of period. Logistic regression with ferritin status, clots, and changing rate during full flow correctly predicts a loss of >80 mL for 76% of women (n=161 patients; sensitivity, 60%; specificity, 86%). Diagnosis and treatment of patients seem unrelated to the volume of blood loss.
  
  
  CONCLUSIONS
  The subjective judgment of the volume of blood loss is better than has been believed. Clinical features can be combined to predict losses of >80 mL.
authors.affiliation: Division of Community Health Sciences, University of Edinburgh Medical School, Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology, Edinburgh, Scotland, United Kingdom.
authors.forename: Pamela E
authors.initials: PE
authors.lastname: Warner
authors.forename: Hilary O D
authors.initials: HO
authors.lastname: Critchley
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Lumsden
authors.forename: Mary
authors.initials: M
authors.lastname: Campbell-Brown
authors.forename: Anne
authors.initials: A
authors.lastname: Douglas
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Murray
mesh_terms: D000328:Adult; D017677:Age Distribution; D001810:Blood Volume; D005260:Female; D006306:Health Surveys; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D016015:Logistic Models; D008595:Menorrhagia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D052576:Menstrual Hygiene Products; D008598:Menstruation; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires