A Scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems.

Objective: To determine the prevalence of self-reported menstrual symptoms and problem periods and explore their relationship with sociodemographic factors, parity, long-standing illness, and hormonal contraceptive use.

Study Design And Setting: Postal questionnaire survey of 4,610 women aged 25-44 registered with 19 general practices in Lothian, Scotland.

Results: Among menstruating women, 30% reported heavy periods, a further 5% very heavy periods and 15% severe period pain. Although 39% of women reported either heaviness or pain or both, only 22% reported their periods as a marked or severe problem. Multivariate logistic regression showed that reporting problem periods was associated with long-standing illness, heaviness of bleeding, menstrual pain and inversely associated with hormonal contraceptive use. Reporting problem periods was strongly associated with severe pain (OR = 21, 95% CI = 15-28) and with very heavy loss (OR = 14, 95% CI = 8.0-24).

Conclusions: Reporting heavy or painful periods was common but reporting problem periods was less so. Reporting severe pain was at least as strongly associated with problem periods as very heavy periods and severe pain affected many more women than very heavy periods. Therefore the clinical preoccupation with heavy periods does not reflect the epidemiology of menstrual symptoms or problem.