Validation of a new menstrual pictogram (superabsorbent polymer-c version) for use with ultraslim towels that contain superabsorbent polymers.

OBJECTIVE: To validate the menstrual pictogram (superabsorbent polymer-c version) for Always Ultra-slim feminine towels containing superabsorbent polymers. DESIGN: Prospective, multicenter, evaluator-blinded study. SETTING: Three gynecology research clinics in the United Kingdom. PATIENT(S): Women with self-perceived light, normal, or heavy menstrual periods who had not previously used a graphical method to assess their menstrual loss. INTERVENTION(S): One hundred twenty-two women were asked to complete the menstrual pictogram throughout two menstrual periods and collect their feminine towels for measurements of menstrual blood loss (MBL) by the alkaline hematin method and total menstrual fluid loss (MFL) by fluid weight. MAIN OUTCOME MEASURE(S): Agreement of menstrual pictogram MBL and MFL scores with alkaline hematin and towel weight, respectively. The percentage blood fraction was determined at various volumes of menstrual discharge. RESULT(S): Alkaline hematin and fluid weight were highly correlated (r = .97). However, the percentage blood fraction progressively increased with total MFL and MBL score. After correction for this incremental rise in blood fraction, the menstrual pictogram gave a sensitivity of 82% and a specificity of 92% for a diagnosis of heavy menstrual bleeding. CONCLUSION(S): The menstrual pictogram (superabsorbent polymer-c version) provides a simple means of measuring MBL in the clinical setting.

A new menstrual pictogram for use with feminine products that contain superabsorbent polymers.

OBJECTIVE: To determine whether the menstrual pictogram (the superabsorbent polymer-c or SAP-c version) can reliably estimate blood and total menstrual fluid volumes on prestained Always Ultra slim feminine towels (Proctor & Gamble) that contain superabsorbent polymers. DESIGN: Randomized blinded study using simulated menstrual fluid (SMF: 50% blood, 50% saline mixture). SETTING: Gynecology research clinic. PATIENT(S): 12 premenopausal women with regular menstrual cycles who had not previously used a graphical method to assess menstrual loss. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Assignment of 135 prestained towels containing known volumes of 0.5-25.0 mL of SMF to five pictorial icons of the menstrual pictogram, and correlation of pictogram scores to blood recovered from towels by the alkaline hematin method and total fluid applied to towels by measurement of soiled towel weight. RESULT(S): There was a high level of agreement between individual scores. For 112 (83%) of 135 towels, the participants' readings either completely concurred or differed by only a single icon. There was a statistically significant correlation between the volume of blood applied (SMF/2) and that recovered by alkaline hematin, and volume of fluid applied and soiled towel weight. CONCLUSION(S): The menstrual pictogram (SAP-c version) is a potential diagnostic tool for heavy menstrual bleeding and would be suitable for testing in a clinical trial.

Validation of a rapid alkaline hematin technique to measure menstrual blood loss on feminine towels containing superabsorbent polymers.

OBJECTIVE: To validate the semiautomated alkaline hematin technique for rapid measurement of menstrual blood loss on ultrathin sanitary towels with a superabsorbent polymer component. DESIGN: Laboratory study using simulated menstrual fluid (SMF) and Always Ultra Normal, Long, and Night "with wings" sanitary towels. SETTING: Laboratorium für Klinische Forschung, Germany. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Linearity and blood recovery over a range of SMF volumes applied to towels, the lower limit of reliable detection, and the effect of storing soiled towels for up to 5 weeks at 20°C and 4°C before analysis, were determined. Recovery from 63 SMF samples comprising between 5% to 100% blood and 0.05-35 mL applied volume was compared with duplicates analyzed at Keele Menstrual Disorders Laboratory (manual reference method). RESULT(S): Linearity was confirmed, and ≥85% recovery was reproducibly achieved at up to 30 mL applied blood at all tested SMF compositions, except at low volume or high dilution equivalent to <4 mL blood. Samples could be stored for 3 weeks at 4°C without loss of recovery. Linear regression analysis showed good agreement with the reference method. CONCLUSION(S): The semiautomated alkaline hematin technique is a reliable method for measuring menstrual blood loss from Always Ultra sanitary towels containing superabsorbent polymers.

Menstrual blood loss measurement: validation of the alkaline hematin technique for feminine hygiene products containing superabsorbent polymers.

OBJECTIVE: To validate the alkaline hematin technique for measurement of menstrual blood loss using ultra-thin sanitary towels that contain superabsorbent polymer granules as the absorptive agent. DESIGN: Laboratory study using simulated menstrual fluid (SMF) and Always Ultra Normal, Long, and Night "with wings" sanitary towels. SETTING: Keele Menstrual Disorders Laboratory. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Recovery of blood, linearity, and interassay variation over a range of SMF volumes applied to towels. Because of the variable percentage of blood in menstrual fluid, blood recovery was assessed from SMF constituted as 10%, 25%, 50%, and 100% blood. The lower limit of reliable detection and the effect of storing soiled towels for up to 4 weeks at 15°C-20°C, 4°C, and -20°C before analysis were determined. RESULT(S): Ninety percent recovery was reproducibly achieved up to 30 mL applied volume at all tested SMF compositions, except at low volume or high dilution equivalent to <2 mL whole blood. Samples could be stored for 3 weeks at all tested temperatures without loss of recovery. The technique was suitable for processing towels individually or in batches. CONCLUSION(S): The alkaline hematin technique is a suitable and validated method for measuring menstrual blood loss from Always Ultra sanitary towels that contain superabsorbent polymers.