The clinical evaluation of unexplained menorrhagia and its treatment with danazol and norethisterone

Menstrual blood loss in both the "normal" and "menorrhagia" populations has only rarely been objectively quantified. This study of menstrual volumes of over 250 individuals sought to add to our existing sparse knowledge in this field. As menstrual blood loss increased, the incidence of anaemia rose. Menstrual blood volume was found to be positively associated with the number of sanitary items used per period, the duration of bleeding, height, the number of pregnancies, and the number of births. No relationship was identified between blood loss and ovulatory status. From work in this thesis and that of previous authors, it is apparent that approximately 50% inaccuracy results from reliance upon patient perception to diagnose menorrhagia. A pictorial blood loss assessment chart was developed, in an attempt to overcome this, with a method which could be widely used and without requiring laboratory facilities. Similarly, medical treatment for menorrhagia is infrequently subjected to objective measurement. Presented in this thesis are the results of a randomised, placebo controlled study, comparing the effects of danazol 200mg, a reducing regimen of danazol and norethisterone in the treatment of objectively quantified unexplained menorrhagia. Both regimens of danazol were more successful in controlling menstrual blood loss than norethisterone.