Quantification of menstrual flow by weighing protective pads in women with normal, decreased or increased menstruation

Gudmundsdottir, Brynja R.; Hjaltalin, Elin F.; Bragadottir, Gudrun; Hauksson, Arnar; Geirsson, Reynir Tómas; Önundarson, Páll T.

doi:10.1080/00016340802673162

Cited by 15 publications

(10 citation statements)

References 23 publications

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“…The relationship between MBL and MFL was considered in four studies, three of which used the alkaline hematin method as the comparator [ 27 , 44 , 48 ]. In all four studies, including one that validated MFL measurements with a selected brand of SAP-c towels [ 46 ], there was a correlation between MFL and either MBL or change in MBL ( r = 0.88–0.97; P = .001–.0001; Additional file 5 ) [ 27 , 44 , 46 , 48 ]. In a fifth study, MBL estimated from MFL correlated, but was not interchangeable, with MBL measured by the alkaline hematin method ( r = 0.73; P < .00001; Additional file 5 ) [ 84 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of methods to measure menstrual blood loss

Magnay¹,

O’Brien

Gerlinger

et al. 2018

BMC Women's Health

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BackgroundSince the publication over 50 years ago of the alkaline hematin method for quantifying menstrual blood loss (MBL) many new approaches have been developed to assess MBL. The aim of this systematic review is to determine for methods of measuring MBL: ability to distinguish between normal and heavy menstrual bleeding (HMB); practicalities and limitations in the research setting; and suitability for diagnosing HMB in routine clinical practice.MethodsEmbase®™, MEDLINE®, and ClinicalTrials.gov were screened for studies on the development/validation of MBL assessment methods in women with self-perceived HMB, actual HMB or uterine fibroids, or patients undergoing treatment for HMB. Studies using simulated menstrual fluid and those that included women with normal MBL as controls were also eligible for inclusion. Extracted data included study population, results of validation, and advantages/disadvantages of the technique.ResultsSeventy-one studies fulfilled the inclusion criteria. The sensitivity and/or specificity of diagnosing HMB were calculated in 16 studies of methods involving self-perception of MBL (11 pictorial), and in one analysis of the menstrual-fluid-loss (MFL) method; in 13 of these studies the comparator was the gold standard alkaline hematin technique. Sensitivity and specificity values by method were, respectively: MFL model, 89, 98%; pictorial blood loss assessment chart (PBAC), 58–99%, 7.5–89%; menstrual pictogram, 82–96%, 88–94%; models/questionnaires, 59–87%, 62–86%, and complaint of HMB, 74, 74%. The power of methods to identify HMB was also assessed using other analyses such as comparison of average measurements: statistical significance was reported for the PBAC, MFL, subjective complaint, and six questionnaires. In addition, PBAC scores, menstrual pictogram volumes, MFL, pad/tampon count, iron loss, and output from three questionnaires correlated significantly with values from a reference method in at least one study. In general, pictorial methods have been more comprehensively validated than questionnaires and models.ConclusionsEvery method to assess MBL has limitations. Pictorial methods strike a good balance between ease of use and validated accuracy of MBL determination, and could complement assessment of HMB using quality of life (QoL) in the clinical and research setting.Trial registrationPRISMA registration number: CRD42016032956.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0627-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A systematic review of methods to measure menstrual blood loss

Magnay¹,

O’Brien

Gerlinger

et al. 2018

BMC Women's Health

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“…menstrual flow as normal, decreased or increased may be possible by weighing standardized pads, but that approach does not quantify actual blood loss [10]. Monitoring changes in serum hemoglobin can be suggestive of excessive blood loss, but it may be difficult to control for the impacts of diet and iron supplementation.…”

Section: Drug Evaluation -Nelsonmentioning

confidence: 97%

Levonorgestrel Intrauterine System: A First-Line Medical Treatment for Heavy Menstrual Bleeding

Nelson

2010

Womens Health (Lond Engl)

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Chronic heavy menstrual bleeding is a common gynecologic condition that causes significant health problems and negatively impacts a woman's quality of life. Surgical treatments should be reserved for women who have pelvic pathology and for those who fail medical therapy. The recent US FDA approval of the levonorgestrel-releasing intrauterine system as an indicated treatment for heavy menstrual bleeding in women who want to use intrauterine devices for birth control highlights the potential that this top tier contraceptive method offers as a first-line therapy for treatment of this problem in women of any reproductive age, without sacrificing their future fertility.

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“…Laboratory methods of blood loss measurement are more accurate than visual estimation (21)(22)(23). The alkaline hematin technique remains the ''gold standard'' against which simpler, less-precise methods have been validated, such as the pictorial blood loss assessment chart (PBAC) (24), the menstrual pictogram (25), and soiled towel weight (26,27). However, the following caveats should be observed.…”

Section: Figurementioning

confidence: 98%

Menstrual blood loss measurement: validation of the alkaline hematin technique for feminine hygiene products containing superabsorbent polymers

Magnay¹,

Nevatte²,

Dhingra

et al. 2010

Fertility and Sterility

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Quantification of menstrual flow by weighing protective pads in women with normal, decreased or increased menstruation

Abstract: Measurement of menstrual flow total weight accurately reflects clinically assessed normal, increased and decreased flow. The method is an easy and accurate way of objectively estimating menstrual flow.

Cited by 15 publications

References 23 publications

A systematic review of methods to measure menstrual blood loss

A systematic review of methods to measure menstrual blood loss

Levonorgestrel Intrauterine System: A First-Line Medical Treatment for Heavy Menstrual Bleeding

Menstrual blood loss measurement: validation of the alkaline hematin technique for feminine hygiene products containing superabsorbent polymers

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