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Table 2 Additional advantages and disadvantages of methods to measure menstrual blood loss

From: A systematic review of methods to measure menstrual blood loss

Method

Advantages

Disadvantages

Alkaline hematin

• “Gold standard” in terms of accuracy

• Has undergone considerable development to improve rapidity; validated for selected SAP-c towels

• Well suited to research setting

• Best used in conjunction with a pictorial method and a diary

• Requires calibration curves for each product and does not take extraneous blood loss into account

• Patients in the clinical setting may be deterred by having to collect, store, and send sanitary products for analysis

Gynaeseal/Mooncup

• Requires few changes per day

• Subject to leakage during collection and therefore unsuitable for either clinical or research purposes

MFL

• Simple

• Can be used to measure effect of medical intervention

• Requires collection of used sanitary products and pre- and post-use weighing

• Sanitary item must be stored in a sealed container before weighing to minimize fluid evaporation

Duration of period

• Simple and easy

• Participants must record/recall results

Counts of pads

• Simple and easy

• Participants must record/recall results

• Frequency of changing pads can be influenced by many variables

Measurement of iron/labelled red blood cells

• Most methods are accurate

• Technically challenging to perform, requires specialist equipment, and is therefore most suited to research

PBAC

• Quick and simple

• Has undergone extensive development; validated for selected SAP-c towels

• Suitable for research purposes and has potential value in the clinic

• Only validated for a limited number of current products

• Participants must record/recall results

Menstrual pictogram

• Quick and easy

• Has undergone development; validated for selected SAP-c towels

• Suitable for research purposes and has potential value in the clinic

• Differentiates between absorbency ratings of sanitary items

• Only validated for a limited number of current products

• Participants must record/recall results

Question-naires

• Many available, ranging in complexity, with questions relating to MBL, generic or disease-specific QoL, or both

• Poorly validated, with a few exceptions

• Participants must record/recall results

Self-perception

• Simple

• Useful for clinical assessments

• Does not give precise MBL measure

• Participants must record/recall results

• Individuals can be poor judges of MBL

• Not diagnostic

  1. MBL menstrual blood loss, MFL menstrual fluid loss, PBAC pictorial blood loss assessment chart, QoL quality of life, SAP-c superabsorbent polymer-containing