{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:26:36Z","timestamp":1789593996031,"version":"build-2803163510"},"reference-count":7,"publisher":"BMJ","issue":"1","funder":[{"name":"Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services","award":["H30MC24049"],"award-info":[{"award-number":["H30MC24049"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH","award":["K12HD043488"],"award-info":[{"award-number":["K12HD043488"]}]},{"DOI":"10.13039\/100000124","name":"Office of Research on Women\u2019s Health","doi-asserted-by":"crossref","award":["K12HD043488"],"award-info":[{"award-number":["K12HD043488"]}],"id":[{"id":"10.13039\/100000124","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2023,6,21]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Heavy menstrual bleeding affects up to one third of menstruating individuals and has a negative impact on quality of life. The diagnosis of heavy menstrual bleeding is based primarily on history taking, which is highly dependent on traditional disposable menstrual products such as pads and tampons. Only tampons undergo industry-regulated testing for absorption capacity. As use of alternative menstrual products is increasing, there is a need to understand how the capacity of these products compare to that of standard products.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A variety of commercially available menstrual products (tampons, pads, menstrual cups and discs, and period underwear) were tested in the laboratory to determine their maximal capacity to absorb or fill using expired human packed red blood cells. The volume of blood necessary for saturation or filling of the product was recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 21 individual menstrual hygiene products tested, a menstrual disc (Ziggy, Jiangsu, China) held the most blood of any product (80\u2009mL). The perineal ice-activated cold pack and period underwear held the least (&lt;3\u2009mL each). Of the product categories tested, on average, menstrual discs had the greatest capacity (61\u2009mL) and period underwear held the least (2\u2009mL). Tampons, pads (heavy\/ultra), and menstrual cups held similar amounts of blood (approximately 20\u201350\u2009mL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study found considerable variability in red blood cell volume capacity of menstrual products. This emphasises the importance of asking individuals about the type of menstrual products they use and how they use them. Further understanding of capacity of newer menstrual products can help clinicians better quantify menstrual blood loss, identify individuals who may benefit from additional evaluation, and monitor treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2023-201895","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T20:00:13Z","timestamp":1691438413000},"page":"21-26","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding"],"prefix":"10.1136","volume":"50","author":[{"given":"Emma","family":"DeLoughery","sequence":"first","affiliation":[{"name":"Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa C","family":"Colwill","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Edelman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9981-8990","authenticated-orcid":false,"given":"Bethany","family":"Samuelson Bannow","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"2025090221415347000_50.1.21.1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00097.x"},{"key":"2025090221415347000_50.1.21.2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12709"},{"key":"2025090221415347000_50.1.21.3","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1097\/AOG.0000000000005126","article-title":"Menstrual technology innovations and the implications for heavy menstrual bleeding","volume":"141","author":"Liberty","year":"2023","journal-title":"Obstet Gynecol"},{"key":"2025090221415347000_50.1.21.4","doi-asserted-by":"publisher","DOI":"10.1074\/mcp.M112.018390"},{"key":"2025090221415347000_50.1.21.5","doi-asserted-by":"crossref","first-page":"102261","DOI":"10.1016\/j.jogoh.2021.102261","article-title":"Menstrual hygiene products: a practice evaluation","volume":"51","author":"Parent","year":"2022","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"2025090221415347000_50.1.21.6","doi-asserted-by":"publisher","DOI":"10.1159\/000320336"},{"key":"2025090221415347000_50.1.21.7","doi-asserted-by":"crossref","DOI":"10.1177\/17455065211058553","article-title":"Comparison between menstrual cups: first step to categorization and improved safety","volume":"17","author":"Manley","year":"2021","journal-title":"Womens Health (Lond)"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2023-201895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T04:42:05Z","timestamp":1756874525000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2023-201895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,7]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bmjsrh-2023-201895"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2023-201895","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,7]]}}}