What is the definition of heavy menstrual bleeding according to Comprehensive Gynecology (Comprehensive Gynecology) 8th edition?

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From the Research

Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman's physical, social, emotional, and/or material quality of life, with no specific volume of blood loss required for diagnosis, as stated in the most recent and highest quality study 1. According to the latest evidence, the definition of heavy menstrual bleeding has shifted from a focus on the volume of blood loss to a more patient-centered approach, considering the impact on quality of life 1. The condition may be caused by various factors, including structural abnormalities, coagulopathies, endocrine disorders, or may be idiopathic (no identifiable cause) 2, 1. Key characteristics of heavy menstrual bleeding include prolonged bleeding, frequent changing of sanitary products, passage of large blood clots, and the need to use double sanitary protection 3, 2. The impact on quality of life is significant, with many women experiencing fatigue due to iron deficiency anemia, restrictions in daily activities, and psychological distress 3, 2, 1. Treatment options depend on the underlying cause and may include hormonal medications, non-hormonal medications like tranexamic acid, or surgical interventions in more severe cases 3, 2, 1. It is essential to note that the definition and management of heavy menstrual bleeding have evolved over time, and the most recent guidelines should be consulted for the best practice 1. In clinical practice, a comprehensive approach to diagnosing and managing heavy menstrual bleeding is crucial, taking into account the patient's symptoms, medical history, and quality of life 4. The most recent and highest quality study 1 provides the best evidence for defining heavy menstrual bleeding and guiding its management, prioritizing the patient's quality of life and individual circumstances.

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