Abstract
Menorrhagia (heavy menstrual bleeding) is a common gynaecological problem and has a major impact on women's general health and quality of life. Management of menorrhagia should aim to improve these aspects rather than focusing on actual reduction in menstrual blood loss. Actual menstrual blood loss (MBL) can only be measured precisely by the alkaline haematin method to extract its haemoglobin content. This is a sophisticated laboratory test and not practical for clinical use. In addition, blood loss only makes up to half of the total menstrual loss [1] and does not necessarily reflect the women's complaints and the adverse effect of heavy menstrual flow on their quality of life.
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