SIMPLE VISUAL ASSESSMENT TECHNIQUE TO DISCRIMINATE BETWEEN MENORRHAGIA AND NORMAL MENSTRUAL BLOOD-LOSS

Objective: To validate a simple, highly predictive test to discriminat e between menorrhagia and normal menstrual blood loss. Methods: The sa nitary wear of 489 menstrual bleeding episodes was collected by 288 wo men for objective measurement of menstrual blood loss (alkaline hemati n method); the women made a subjective assessment of the volume and, b ased on a pictorial chart, recorded the amount of and the degree to wh ich their sanitary wear was soiled. Based on that degree, a score was calculated for each episode and a suitable cutoff point was chosen, ab ove which the presence of menorrhagia was likely and below which it wa s unlikely. Results: Using a score of 185 as the cutoff point, the pre dictive values of positive and negative tests were almost equally high , 85.9 and 84.8%, respectively. Whether or not the presence of clots w as recorded, these values did not change. The predictive value of a wo man's complaint of heavy bleeding for the presence of menorrhagia was 55.9% and that of anemia (hemoglobin less than 12.0 g/dL) was 74.4%. C onclusion: We validated and refined a new, simple, visual assessment t echnique and demonstrated that it is superior to a woman's subjective assessment of menstrual blood loss and the occurrence of anemia for pr edicting menorrhagia, even if it is performed only once. We also demon strated that the volume that clots contribute to menstruation is not a s large as many clinicians believe. With this technique, the quality o f therapy can be enhanced by making it more adequate and rational.