Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data

Am J Obstet Gynecol. 2004 May;190(5):1216-23. doi: 10.1016/j.ajog.2003.11.015.


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.

Study design: 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.

Conclusion: 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Blood Volume
  • Female
  • Health Surveys
  • Humans
  • Hypovolemia / diagnosis*
  • Hypovolemia / epidemiology
  • Hypovolemia / therapy
  • Logistic Models
  • Menorrhagia / diagnosis*
  • Menorrhagia / epidemiology
  • Menorrhagia / therapy
  • Menstrual Hygiene Products
  • Menstruation*
  • Middle Aged
  • Pain Measurement
  • Predictive Value of Tests
  • Prevalence
  • Probability
  • Risk Assessment
  • Severity of Illness Index
  • Sickness Impact Profile
  • Surveys and Questionnaires