Clinical associations with objective menstrual blood volume

Objective: To determine the association between simple clinical parameters and objective menstrual blood volume. Study Design: A cohort study, in a London teaching hospital. Women complaining of menorrhagia (207) and those who considered their menstruation to be normal (47) were studied. Those with no demonstrable gynaecological pathology had their menstrual blood loss measured using the alkaline haematin technique. Results: Only 49% of 207 women complaining of menorrhagia had a loss of 80 ml or more. There was an increasing incidence of objective menorrhagia with increasing duration of bleeding and use of more sanitary protection items. Increasing height, age and number of intrauterine pregnancies were all associated with increasing menstrual blood volume. Haemoglobin fell with increasing menstrual blood loss. Conclusions: Despite these clinical associations it is difficult to establish the quantity of menstrual bleeding with certainty without an objective assessment.