SynthesisBMC women's health2018
A systematic review of methods to measure menstrual blood loss.
Synthesis in BMC women's health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Pooled it
- Interventions commonly available during pandemics for heavy menstrual bleeding: an overview of Cochrane Reviews.The Cochrane database of systematic reviews · 2020Pooled it
- Reduction of Heavy Menstrual Bleeding in Women Not Designated as Responders to Elagolix Plus Add Back Therapy for Uterine Fibroids.Journal of women's health (2002) · 2022Trial
- Pharmacodynamics and pharmacokinetics of a copper intrauterine contraceptive system releasing ulipristal acetate: A randomized proof-of-concept study.Contraception · 2021Trial
- Correlations between TSC Expression and Menorrhagia in Adenomyosis Patients.Reproductive sciences (Thousand Oaks, Calif.) · 2026Article
- Associations between shift work, sleep quality and menstrual disorders among nurses: a cross-sectional analysis study.BMC nursing · 2026Article
- Heavy Menstrual Bleeding in the Gynecology Clinic: A Call for Awareness and Standardized Screening for Underlying Bleeding Disorders.Obstetrical & gynecological survey · 2026Review
- Article
- The multiple positive effects of Honghua Ruyi Pills combined with estradiol valerate and dydrogesterone tablets on postoperative recovery in women after artificial abortion.Frontiers in medicine · 2026Article
- A retrospective review of diagnosis and management of heavy menstrual bleeding and co-morbidities in patients seen in Young Women's Blood Clinic.Paediatrics & child health · 2025Article
- Association of the Transmembrane Protease Serine 6 rs855791 Variant and Nongenetic Factors With Iron Deficiency Among Female Medical Students in Yogyakarta: Protocol for a Case-Control Study.JMIR research protocols · 2025Article
- Association between menstrual pad usage, self-reported symptoms, and menstrual blood loss measured by the alkaline hematin method.European journal of obstetrics, gynecology, and reproductive biology · 2025Article
- Is integrative therapy of traditional Chinese medicine and progesterone capsule more effective than monotherapies in oligomenorrhea and hypomenorrhea? Evidence based on a multi-center randomized controlled trial and metabolomic profile.Journal of translational internal medicine · 2025Article
- Navigating the future landscape of uterine fibroid research: a comprehensive summary of patient-centered outcome measures and implications.BMC women's health · 2025Article
- Menstrual bleeding-specific quality of life in women on antiplatelet therapy.Research and practice in thrombosis and haemostasis · 2025Article
- Comparison of the effectiveness of hypnotherapy and menstrugol capsules on the volume of menstrual bleeding: A clinical trial study.Journal of education and health promotion · 2025Article
- Quantifying menorrhagia and overview of nonsurgical management of heavy menstrual bleeding.Hematology. American Society of Hematology. Education Program · 2024Review
- Evaluation of menstrual blood loss (MBL) by self-perception and pictorial methods and correlation to uterine myometrial pathology.Archives of gynecology and obstetrics · 2024Article
- Potential for and challenges of menstrual blood as a non-invasive diagnostic specimen: current status and future directions.Annals of medicine and surgery (2012) · 2024Review
- Management of abnormal uterine bleeding on anticoagulation: the patient-clinician perspective.Journal of thrombosis and haemostasis : JTH · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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 .
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.