The Duration of Menstrual Blood Loss: Historical to Current Understanding
Abstract
:1. Introduction
2. Assessing the Duration of Bleeding
3. Identifying the Onset of Bleeding and Its Cessation
4. Assessing Variability
5. The Relation between the Amount of Loss and Its Duration
6. Factors That Affect the Duration of Bleeding
6.1. Mechanisms Involved in Menstruation
6.2. Endometrial Shedding and Its Anomalies
6.3. Triggering the Onset of Bleeding
6.4. The Lifespan of the Corpus Luteum
6.5. Factors That Affect Cessation of Bleeding
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Suggested Cut-Off for Normal |
---|---|
Meigs (1849) [13] | Each woman has her own cycle |
Tauszky (1879) [14] | 10 days can be considered normal |
Fraser et al (2007) [7] | Between 4.5–8 days |
Munro et al (2018) [9] | upper limit of normal > 8 days as, no lower limit |
Bastianelli et al (2023) [10] | Women reported preference of 3 days |
BMI Range | Number of Cycles | Duration of Bleeding (Mean ± Std) |
---|---|---|
15–18.5 | 25,735 | 4.2 ± 1.5 * |
18.5–25 | 431,667 | 4.0 ± 1.5 |
25–30 | 100,228 | 3.9 ± 1.4 * |
30–35 | 26,483 | 3.9 ± 1.4 * |
35–50 | 12,011 | 3.0 ± 1.5 * |
All cycles | 621,613 | 4.0 ± 1.5 |
Study | Observation Related to Duration of Bleeding |
---|---|
Bastianelli et al (2023) [10] | Women regard 3 days as the optimal duration of bleeding |
Zhang et al (2017) [12] | Women who reported their bleeding to last <4 or >5 days had lower fecundity ratio compared to those who reported 4–5 days of bleeding |
Najmabadi et al (2020) [28] | No difference in duration of bleeding based on age (<30 years vs ≥30 years) or parity (nulliparous vs parous) |
Belsey and Pinol (1997) [29] | Mean duration reduced from 6.6 days at 15 y, to 6.0 days by 20 y and remained largely unchanged until age 49 y |
Dasharathy et al (2012) [41] | Longer duration of bleeding in ovulatory compared to anovulatory cycles |
Zurawiecka et al (2021) [44] | No difference in the duration of bleeding between women with early, average, or late menarche |
Mao et al (2021) [45] | Prolonged bleeding in underweight and shorter bleeding in obese women |
Kafaei-Atrian et al (2019) [48] | Duration of bleeding had a significant relationship with weight, and the circumference of waist, hip and arm. A significant relationship between duration and waist-to-height, waist-to-hip, hip-to-height and arm-to-height ratios |
Van Voorhis et al (2008) [58] | Self-reported past diagnosis of fibroids linked to longer duration of bleeding |
Harlow and Campbell (1994) [64] | The duration of bleeding not associated with the length of the preceding cycles, history of long cycles, change in body weight, college entry, or being away from home. Slight increase if late menarche. Longer bleeding if low weight-for-height. |
WHO Task Force (1986) [67] | The duration of bleeding varied between countries and is slightly longer if late menarche. Unaffected by exercise, previous cycle length or gynecologic age. |
Nikolova et al (2003) [69] | The duration of bleeding (4.69 ± 0.05 days) was significantly shorter in left-handed compared to right-handed women (5.75 ± 0.004 days) |
Mollabashi et al (2020) [72] | Duration of bleeding not affected by Chamomile |
Chang et al (2009) [73] | Duration of bleeding linked to obesity |
Tayebi et al (2018) [74] | Link between duration of bleeding and obesity not confirmed |
Zhang et al (2020) [75] | Exposure to high concentration of organophosphate pesticides linked to shorter duration of bleeding |
Wood et al (1979) [76] | Based on patient recollection, the duration of bleeding was 1–7 days and 3% of women bled for >7 days |
Kirchengast (1994) [77] | The post-cephalic height and length dimensions were positively correlated with the duration of bleeding |
Fakeye and Adegoke (1994) [78] | Prolonged bleeding (≥8 days) occurred in less than 5% of postmenarcheal schoolgirls |
Vercellini et al (1997) [79] | The duration of bleeding was longer (mean difference 0.33 days) in women with endometriosis |
Bata (2012) [80] | The duration of bleeding in 73.6% of secondary school students was between 4–7 days. |
Rigon et al (2012) [81] | In women and girls aged (13–21 years), the average duration of bleeding was <4 days in 3.2% of participants and >6 days in 19% of participants |
Farahmand et al (2020) [82] | No difference in the duration of bleeding in postmenarcheal girls with different height centiles |
Ansong et al (2020) [83] | International students in China who had high levels of stress reported abnormal duration of bleeding |
Charis et al (2022) [84] | In women recovering from spinal cord injury, the mean duration of bleeding was lower (4.28 ± 0.96 days) compared to the duration of bleeding before the injury (4.88 ± 0.4 days) |
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Habiba, M.; Benagiano, G. The Duration of Menstrual Blood Loss: Historical to Current Understanding. Reprod. Med. 2023, 4, 145-165. https://doi.org/10.3390/reprodmed4030015
Habiba M, Benagiano G. The Duration of Menstrual Blood Loss: Historical to Current Understanding. Reproductive Medicine. 2023; 4(3):145-165. https://doi.org/10.3390/reprodmed4030015
Chicago/Turabian StyleHabiba, Marwan, and Giuseppe Benagiano. 2023. "The Duration of Menstrual Blood Loss: Historical to Current Understanding" Reproductive Medicine 4, no. 3: 145-165. https://doi.org/10.3390/reprodmed4030015