Measured menstrual blood loss in women with menorrhagia associated with pelvic disease or coagulation disorder.

Fifty-five women with a convincing clinical history of menorrhagia associated with recognizable pelvic disease (40 women) or a confirmed coagulation disorder (15 women) were studied through one or more cycles with measurements of menstrual blood loss volume by a modified alkaline hematin method. Women with leiomyomata almost always exhibited large volumes of menstrual bleeding, which was invariably reduced by myomectomy and sometimes helped by mefenamic acid. Women with other pelvic disease such as endometriosis, adenomyosis, and myometrial hyperplasia also often exhibited genuine menorrhagia that responded to mefenamic acid, whereas others were found to have normal blood loss even when the history was convincing. Some women with coagulation disorders due to platelet dysfunction exhibited gross menorrhagia but others had blood loss within normal limits.