Quantitation of menstrual blood loss — Further evaluation of the alkaline hematin method

Shaw, S.T.; Aaronson, David; Moyer, Dean L.

doi:10.1016/0010-7824(72)90015-7

Cited by 57 publications

(37 citation statements)

References 15 publications

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“…This is important as anovulatory hormones (in the contraceptive pill) are known to reduce menstrual losses by half (16), and intrauterine devices may actually double menstrual losses (17). In women with menorrhagia, MBL exceeded 80 ml in every case (12), a figure that corresponds to 189 ml of MFL.…”

Section: Discussionmentioning

confidence: 99%

“…None of the women was pregnant or breastfeeding, none was taking oral contraceptive therapy for at least 3 months before enrollment, and none had medicated or non-medicated intra-uterine devices. Women with menorrhagia were diagnosed based on an internationally accepted parameter, MBL (12). The women with menorrhagia were exempt of treatments (i.e.…”

Section: Subjectsmentioning

confidence: 99%

“…Hematin extraction was conducted using a modification of the Alkaline Hematin Method (AHM) technique (12,15). Standard spectrophometric analysis (Optical Density [OD]) was used to determine the concentration of hematin in each wear sample, using a standard curve obtained by diluting porcine hematin (Sigma-Aldrich, S. Louis, MO, USA).…”

Section: Measurement Of Iron Loss (Menstrual Iron Losses; Mil)mentioning

confidence: 99%

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Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses

et al. 2013

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In women of fertile age, iron loss consequent to excessive menstrual discharge is by far the most frequent cause of iron-deficient anemia. However, the relationship between menstrual discharge and iron loss is poorly understood. In this prospective study, total menstrual and iron losses were assayed in a large cohort of non-anemic women and women with excessive menstrual blood losses (menorrhagia) in order to provide data useful for intervention. One hundred and five Caucasian women aged 20-45 years were recruited. Blood cell count and serum ferritin (SF) levels were determined in each case before menses. Menstrual Fluid Losses (MFL) were determined using a standardized pads' weight method. Hematin concentration was assayed by a variant of the Alkaline Hematin Method from which iron concentration was calculated. Mean SF levels were 36.2 (range 8.6-100) ng/ml in healthy women and 6.4 (range 5-14) ng/ml in patients with menorrhagia. Median values of iron lost/cycle were 0.87 mg in healthy women and 5.2 mg in patients with menorrhagia (ranges: 0.102-2.569 and 1.634-8.665 mg, respectively, p<0.001). In women with menorrhagia, iron lost/cycle strongly correlated (0.789, p<0.001) with MFL. In conclusion, healthy women with normal menses lose, on average, 1 mg iron/cycle. Average iron losses in patients with menorrhagia are, at least in our cohort, on average, 5-6 times higher than normal. Most women with menorrhagia had totally depleted iron stores. Indirect, quantitative evaluation of iron lost with menses may be useful to assess the risk of developing iron-deficient anemia in individual patients. 3 IntroductionIron is a vital element of metabolism, with the most obvious and known role played in erythropoiesis, and important functions in other intracellular processes in all tissues of the body. The uptake of iron is finely regulated (1). For physiologic iron losses, no known mechanisms of maintaining iron homeostasis have been identified, and losses appear to be related mainly to cell exfoliation (2).

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Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Measurement Of Iron Loss (Menstrual Iron Losses; Mil)mentioning

confidence: 99%

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Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses

et al. 2013

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“…The alkaline hematin test is an objective way of assessing menstrual blood loss by extracting hemoglobin from used sanitary pads, and converting it to hematin which is than measured spectrophotometrically (Hallberg & Nillson, 1964;Shaw et al, 1972). In many studies it was shown to be the accurate and simple method of measuring menstrual blood loss (Cheyne & Shepherd, 1970;Van Eijkeren et al, 1986;Vasilenko et al, 1988;Jannsen et al, 1995;Pendergrass et al, 1984).…”

Section: Direct Measurement By Using the Alkaline Hematin Testmentioning

confidence: 99%

The Management of Dysfunctional Uterine Bleeding

Çorbacıoğlu¹

2011

Update on Mechanisms of Hormone Action - Focus on Metabolism, Growth and Reproduction

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“…Care was taken to counsel women about maximizing the collection of their total menstrual loss, including blood 'clots'. MBL was measured using a modified version of the alkaline haematin method (Hallberg and Nilsson, 1964;Shaw et al, 1972) to quantify haemoglobin in menstrual fluid after detergent extraction. A central laboratory (Laboratorium für Klinische Forschung GmbH, Kiel, Germany) was used to process and analyse all sanitary protection items.…”

Section: Study Assessmentsmentioning

confidence: 99%

Effective treatment of heavy and/or prolonged menstrual bleeding with an oral contraceptive containing estradiol valerate and dienogest: a randomized, double-blind Phase III trial

et al. 2011

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background: This double-blind trial investigated the efficacy and safety of estradiol valerate/dienogest (E 2 V/DNG) for the treatment of heavy menstrual bleeding without recognizable organic pathology.methods: Otherwise healthy women with idiopathic heavy, prolonged or frequent menstrual bleeding, confirmed during a 90-day run-in phase, were randomized (2:1) according to a permuted-block, computer-generated schedule to E 2 V/DNG or placebo for 196 days at 34 centres in Europe and Australia. The primary efficacy end-point was the proportion of women with a 'complete' response (i.e. a return to 'menstrual normality') during a 90-day efficacy phase. Secondary end-points included changes in measured menstrual blood loss (MBL) and iron metabolism parameters. results:The intention-to-treat population comprised 231 women. The E 2 V/DNG response rate was much higher than with placebo (P , 0.0001). The mean reduction in MBL volume in E 2 V/DNG recipients was 69.4% (median 79.2%) versus 5.8% (median 7.4%) in placebo recipients. The between-treatment difference in MBL volume was 373 ml in favour of E 2 V/DNG (95% confidence interval 490, 255 ml; P , 0.0001). Significant improvements in iron metabolism parameters were observed with E 2 V/DNG but not placebo. Overall, 14 women (9.7%) treated with E 2 V/DNG and 5 (6.2%) treated with placebo prematurely discontinued treatment because of adverse events, headache being the most prevalent. Serious adverse events occurred in both the E 2 V/DNG and placebo groups (each n ¼ 2).conclusions: E 2 V/DNG is an effective treatment in women with heavy and/or prolonged menstrual bleeding without organic pathology. Further study of E 2 V/DNG compared with an active comparator is warranted. ClinicalTrials.gov identifier: NCT00307801.

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Quantitation of menstrual blood loss — Further evaluation of the alkaline hematin method

Cited by 57 publications

References 15 publications

Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses

Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses

The Management of Dysfunctional Uterine Bleeding

Effective treatment of heavy and/or prolonged menstrual bleeding with an oral contraceptive containing estradiol valerate and dienogest: a randomized, double-blind Phase III trial

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