Menstrual bleeding patterns: A community-based cross-sectional study among women aged 18-45 years in Southern Brazil

A community-based cross-sectional study was conducted among 18-45 years old women users of the 31 primary health care (PHC) facilities in Pelotas city (Brazil). Interviews with structured questionnaire were carried out in the waiting rooms during two work shifts. Heaviness of menstrual bleeding was determined through the answer to the question: "Usually how much blood do you lose in every period?" Crude and adjusted analyses through Poisson regression took into account the aggregation per PHC facility.A total of 865 women were enrolled. Prevalence of heavy menstrual flow was 35.3% (95% CI 32.1-38.6%). In adjusted analyses, heavy menstrual bleeding was higher among the older, less educated and obese women, with higher number of pregnancies and who reported longer menstrual periods, extra-menstrual bleeding and clots in the flow. Use of hormonal contraceptive methods was protective against heavy menses.Heavy menstrual bleeding is highly prevalent at the community level, and is associated with socio-demographic and anthropometric women's characteristics, as well as with duration of menstruation, extra-bleeding and presence of clots.Menstrual blood loss can vary greatly in quantity and identification of heavy blood loss which may have important impact over women wellbeing and health, may be particularly difficult [1]. Judging heaviness of loss is a complex decision based on personal norm (past experience of periods), difficulty in containing the volume of loss (sanitary protection used), and pattern of loss (presence of clots and flooding) [2].Although abnormal bleeding is among the major causes of gynecologic morbidity [3,4] and in some settings a leading indicator for hysterectomy [5,6], population variation in the duration and amount of menstrual bleeding has been the subject of few researches worldwide. This study describes the duration and amount of menstrual bleeding and investigates the association between heavy menstrual flow and socio-demographic, behavioral, a