The Menstrual Pictogram

The menstrual pictogram was first developed by Prof. O'Brien while working with colleagues, Dr. Jenny Higham and Professor R. Shaw at the Royal Free Hospital in London.  In its initial form it measured only loss on sanitary wear using a series of icons to represent the degree of soiling.  This in itself was a major advance in the quantification of menstrual blood loss, as it was validated against the existing alkaline haematin technique and shown to be an accurate estimation of actual blood loss as measured by that technique.

Subsequently is has been shown to underestimate blood loss at very high levels prevalent in some women [ref], and of course it did not measure extraneous blood loss not retained on sanitary wear.  Our group at Keele have now developed the menstrual pictogram to a more advanced level, so that it both accurately measures large menstrual losses, and fully accounts for extraneous loss.   This has been validated against the alkaline haematin method for sanitary wear loss, and has been developed in a reproducible verifiable manner for extraneous loss, for which no gold standard exists.

A downloadable version of the current menstrual pictogram is available here, together with instruction on how to use it to estimate monthly blood loss.