| Objective1.To collate literature and sort out the menstruation knowledge of Chinese and Western medicine,so as to provide a theoretical basis for the study of menstrual blood loss and menstrual color.2.To explore women’s cognition of menstruation,and to explore a method of menstrual blood loss assessment with high accuracy,good feasibility and high acceptance.3.To discuss the role of standardizing sanitary napkin brand in the study of menstrual color,the sanitary napkin that better show the actual menstrual color was selected out.The various menstrual colors were explored by detecting the real menstrual color,which would standardize the cognition of menstrual color to a certain extent and provide reference for clinical identification of menstrual color.Methods1.Theorotical researchThe relevant theoretical knowledge of menstruation was reviewed.The methods of menstrual blood loss assessment at home and abroad were systematically sorted out,and related researches on menstrual blood loss,menstrual color and menstrual texture were studied.2.Menstrual cognition research2.1 Survey on menstruation cognitionA questionnaire was designed to investigate the basic knowledge of menstruation among475 women to explore menstrual cognition.2.2 Survey on the methods of menstruation blood loss assessmentAccording to the literature,the menstrual blood loss assessment method which were clinically operable and relatively uncomplicated were firstly selected(graphic method,including menstrual pictogram and pictorial blood loss assessment chart).And then 156women participated in the survey to choose the method in order to finally determine the method of evaluating menstrual blood loss.2.3 Study of self-menstrual blood loss assessment66 women were asked to evaluate their menstrual blood loss.The menstrual blood loss was recorded during menstrual period and the accuracy of cognition was discussed by comparing the self-evaluation and actual menstrual blood loss.3.Menstrual color study3.1 Experiment on color difference of sanitary napkinDuck blood was used to simulate menstrual blood,and blood color was detected by naked eye observation and color detector.The color of 19 different brands of sanitary napkins was compared at 5 time points(1 minute,5 minutes,15 minutes,30 minutes,1 hour),and the sanitary napkin that could better reflect the actual blood color was selected as the unified sanitary napkin for the next research.3.2 Study of menstrual color and color card making based on real menstruationThe unified brand of sanitary napkins were distributed to 15 women,and the real menstrual color of 1-3 menstrual cycles was detected by color detector.The cluster centers of 5 menstrual colors were obtained by cluster analysis to provide 5 menstrual reference colors,and an electronic menstrual color card was made.Results1.Theorotical research1.1 Understanding of menstruation in traditional Chinese and western medicineTraditional Chinese medicine and western medicine have roughly similar understanding about menstruation(periodicity,menstrual period,menstrual blood loss,menstrual color and menstrual texture).Traditional Chinses medicine attaches great importance to menstrual blood loss,color and texture,while western medicine pays less attention to menstrual color and texture.The standard range of menstrual blood loss is not unified at present,and menorrhagia is defined as menstrual blood loss exceeds 80ml.1.2 Methods of menstrual blood loss assessmentThere were many methods to evaluate menstrual blood loss at home and abroad,including the alkaline hematin method,determination of iron content in menstrual blood,radioisotope counting method,graphic method(menstrual pictogram and pictorial blood loss assessment chart)and physical method.Due to its’cumbersome and not easily acceptable by women,these methods have not been popularized and applied.Because of the characteristics of menstruation,it is difficult to accurately evaluate the menstrual blood loss.1.3 Study on menstrual color and textureThere was no specific description of the connotation of menstrual color in the medical books of past dynasties.And there was less modern research on the menstrual color and texture.According to the literatures,the menstrual color could be divided into 5 categories:light red,bright red,dark red,yellowish brown and blackening.2.Menstrual cognition research2.1 Survey on menstrual cognition2.1.1 Basic informationA total of 475 electronic questionnaires were collected,among which 10-17 years old women accounted for 0.84%,18-35 years old women accounted for 77.47%and 36-55 years old women accounted for 21.69%.The females were composed of unmarried women(64.63%),married women(33.69%)and divorced women(1.68%).93.47%of the women had college education or above,and 56.21%of them had medical background(among which 73.04%were women majoring in traditional Chinese medicine).2.1.2 Menstrual cognition2.1.2.1 PeriodicityThe correct rate of choosing regular menstruation and irregular menstruation was 60.21%and 54.95%respectively.The total correct rate of cognition of menstruation regularity was41.89%,which was lower than the incorrect rate(56.00%).2.11%of women did not know the regularity of menstruation.2.1.2.2 Menstrual period80.00%and 78.95%of the women chose the concept of menstrual cycle and normal menstrual cycle correctly,and 20.00%and 21.05%of the women failed to know the concept of menstrual cycle and normal menstrual cycle correctly.2.1.2.3 AmenorrheaOnly 39.16%of the women chose amenorrhea correctly,56.84%of the women chose amenorrhea wrongly,and 4.00%of the women did not know amenorrhea.2.1.2.4 Menstrual period30.95%of the women had correct choice of menstrual period,while 69.05%of the women failed to correctly choose or understand menstrual period.2.1.2.5 Menstrual blood lossThe correct rate of choosing the upper and lower limits of normal menstrual blood loss was low(19.79%).The wrong rate of choosing menorrhagia/hypomenorrhea was high(71.58%).And 8.63%of women did not know menorrhagia/hypomenorrhea.2.1.2.6 Menstrual colorThe correct rate and wrong rate of women’s choices of menstrual color were 40.42%and 58.32%respectively.1.26%of women did not know the normal menstrual color.2.1.2.7 Menstrual textureThe correct rate and wrong rate of women’s choices of menstrual texture were 64.84%and 32.63%respectively.2.53%of women did not know the normal menstrual texture.2.1.2.8 The overall cognitionOnly 0.84%of women correctly selected all the subjects of menstruation knowledge.2.1.2.9 Sources of menstruation cognitionThe 475 women selected the cognitive sources of menstruation 1199 times.385women’s cognition of menstruation came from their own menstruation(32.11%of total frequency).272 women and 216 women knew about menstruation through relevant professional books(22.69%of total frequency)and communication with others(18.02%of total frequency)respectively.Women knew about menstruation through a variety of ways.2.2 Study on menstruation blood loss assessment2.2.1 Survey on the methods of menstruation blood loss assessmentA total of 156 women completed the electronic questionnaire.The results showed that48.72%of women thought that the menstrual pictogram was easier to understand,while 23.72%of women thought that pictorial blood loss assessment chart was easier to understand.26.92%of women thought that the two methods were both easy to understand.And the remaining0.64%of women thought that neither the two methods were easy to understand.70.51%of women tended to use menstrual pictogram to record menstrual volume.77.56%of women thought that menstrual pictogram could better reflect menstruation blood loss.2.2.2 Study on self-assessment of menstrual blood loss2.2.2.1 Basic information of the objectsA total of 66 women were included,ranging from 21 years old to 43 years old,with an average age of 24.18±3.53 years old.The minimum BMI was 15.15 kg/m~2 and the maximum BMI was 23.23 kg/m~2,with an average BMI of 19.36±1.88 kg/m~2.2.2.2.2 The results of self-assessment of menstrual blood lossThe correct rate and incorrect rate of women’s self-assessment of menstrual blood loss were 59.09%and 40.91%respectively.The statistical results showed that there was no significant difference between the self-assessment of menstrual blood loss and the actual menstrual blood loss.3.Study on menstrual color3.1 Experiment on color difference of sanitary napkinThere were differences in the display of the same blood color among 19 different brands of sanitary napkins,and the color of each brand of sanitary napkins changed at five time points.In terms of naked eye observation and color detector,the difference between the display color of sanitary napkin M and the actual blood color was smaller than that of other brands of sanitary napkins,and within 30 minutes after sanitary napkin M stained with blood was a better time to show the blood color.3.2 Study of menstrual color and color card making based on real menstruationA total of 15 women were included,and 100 color data were collected.Five color clustering centers were obtained,which were light red(Lab:75,24,6),bright red(Lab:45,57,30),dark red(Lab:38,40,18),yellowish brown(Lab:63,8,22),blackening(Lab:29,9,8).Menstruation color card was made according to the result.Conclusion1.The basic knowledge about menstruation(periodicity,menstrual period,menstrual blood loss,menstrual color and menstrual texture)in traditional Chinese medicine and western medicine is roughly similar.The range of menstrual blood loss is not unified so far.Standardization of menstruation is still a difficult problem.Syndrome differentiation in traditional Chinese medicine should be combined with menstrual color and texture,but there is a lack of normative research of this area.2.Women’s understanding of menstruation mainly comes from their own menstruation,which has problems such as inaccurate and incomplete cognition.The menstruation information obtained by the current clinical inquiry mode is not very reliable,so it is necessary to conduct a normative study of menstruation.Menstrual pictogram is a method of menstrual blood loss assessment that can be easily understood and used by women.3.The menstrual color determination needs a relatively scientific method.Unified sanitary napkin should be used in the study of menstrual color.It is necessary to develop menstrual color card for clinical use.According to the results of this study,LAB:75,24,6;LAB:45,57,30;LAB:38,40,18;LAB:63,8,22;LAB:29,9,8 are respectively being light red,bright red,dark red,yellowish brown and blackening to make menstrual color card.However,the sample size needs to be expanded for further verification. |
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