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

The menstrual pictogram (superabsorbent polymer-c version) is a simple semiquantitative method that can be used to diagnose heavy menstrual bleeding and would be suitable to test treatment effects in clinical trials.


Julia Lindsey Magnay, M.Sc., Tracy M. Nevatte, Ph.D., Shaughn O’Brien, D.Sc., Christoph Gerlinger, Ph.D., Christian Seitz, M.D.

Volume 101, Issue 2, Pages 515-522.e5, February 2014



To validate the menstrual pictogram (superabsorbent polymer-c version) for Always Ultra-slim feminine towels containing superabsorbent polymers.


Prospective, multicenter, evaluator-blinded study.


Three gynecology research clinics in the United Kingdom.


Women with self-perceived light, normal, or heavy menstrual periods who had not previously used a graphical method to assess their menstrual loss.


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.


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.


The menstrual pictogram (superabsorbent polymer-c version) provides a simple means of measuring MBL in the clinical setting.

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