The Pictorial Blood Loss Assessment Chart (PBAC) turns the pads, tampons and clots you use over a period into a score that shows whether the bleeding is heavy. This page has a printable day 1–8 tally sheet with the point values, how the scoring works, what the three saturation pictures stand for, and how the PBAC and the related Menstrual Assessment Chart define a "large" clot. To read a finished total, see PBAC score interpretation on the calculator page.
Open PeriodVol — the digital versionIt's a simple way to estimate how much you bleed without a laboratory test. Each day of your period you record how many pads or tampons you changed and how soaked they were, plus any clots or flooding. Each item is worth points (or, in PeriodVol, an estimated volume), and the total tells you whether your bleeding is in the normal range or heavy. These charts are widely used by doctors because objective blood-loss measurement (the laboratory "alkaline-haematin" method) isn't practical in everyday care.
The PBAC was introduced by Higham, O'Brien & Shaw in 1990 and is the most widely used pictorial chart. You match each product to a picture showing how stained it is, and add up the points for the whole period.
| Item | Lightly stained | Moderately soaked | Fully saturated |
|---|---|---|---|
| Pad | 1 pt | 5 pts | 20 pts |
| Tampon | 1 pt | 5 pts | 10 pts |
Plus: small clot = 1 point, large clot = 5 points, and each episode of flooding = 5 points. A total of 100 or more indicates probable heavy menstrual bleeding (menorrhagia), which corresponds to roughly more than 80 ml of blood loss per cycle. You can add up your own total with the free PBAC score calculator, and what each range means is set out there under PBAC score interpretation.
The original chart shows each level as a drawing of a pad or tampon. In words — ours, not the chart's — lightly stained is a small mark with most of the product still clean; moderately soaked is blood across roughly half of it; fully saturated is soaked edge to edge. The judgement between "moderate" and "saturated" is the one that moves a total most, since a saturated pad is worth four moderate ones, so decide how you will call it and keep calling it the same way for the whole period.
The scoring above on one sheet. Print it, keep it where you change, and make a tally mark in the row that matches each pad or tampon as you go. At the end of the period, count the marks in each row, multiply by the points, and add the row totals.
| Item | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | Day 8 | Marks | Points | Row total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Pad — lightly stained | × 1 | ||||||||||
| Pad — moderately soaked | × 5 | ||||||||||
| Pad — fully saturated | × 20 | ||||||||||
| Tampon — lightly stained | × 1 | ||||||||||
| Tampon — moderately soaked | × 5 | ||||||||||
| Tampon — fully saturated | × 10 | ||||||||||
| Small clot smaller than a ~2.5 cm coin | × 1 | ||||||||||
| Large clot a ~2.5 cm coin or bigger | × 5 | ||||||||||
| Flooding leaked onto clothes or bedding | × 5 | ||||||||||
| Total PBAC score for this period (add the row totals) — 100 or more suggests heavy menstrual bleeding | |||||||||||
Prefer to add it up on screen? Enter the row counts into the PBAC score calculator. Prefer not to count at all? PeriodVol logs the same pads and tampons with a tap and estimates the volume in millilitres.
Several health organisations publish their own version of the pictorial chart, all based on Higham's PBAC but with small differences — especially in how a clot's size is defined:
Since the original PBAC, several validated pictorial charts have been published. They fall into two types — those that give an abstract point score, and those calibrated to actual millilitres of blood (validated against the laboratory alkaline-haematin method):
| Chart | Output | Notes |
|---|---|---|
| PBAC — Higham 1990 | Points | The original; a score ≥ 100 suggests heavy bleeding. |
| Janssen chart — 1995 | Points | Refined visual chart; cut-off 185. |
| Barr chart — 1999 | Points | Pictorial chart developed for adolescents. |
| Wyatt pictogram — 2001 | Millilitres | Each icon = an actual mL value, validated vs alkaline haematin. |
| Magnay pictogram — 2014 | Millilitres | mL calibrated for modern superabsorbent ("ultra") towels. |
PeriodVol reports millilitres, like the Wyatt and Magnay pictograms, and also shows a PBAC-equivalent point score in its doctor report — so the result is comparable to whichever chart a clinician is used to.
There is no single universal cut-off, so charts vary. This is the comparison most people are looking for:
| Source | A "large" clot is… | Approx. size |
|---|---|---|
| Menstrual Assessment Chart (Canadian Hemophilia Society) | larger than 1 cm | ~1 cm |
| General HMB guidance (NHS / ACOG) | bigger than a 2.5 cm / 1 inch coin | ~2.5 cm |
| PeriodVol app | about a coin (~2.5 cm) — e.g. an Australian $1 coin | ~2.5 cm |
| Australian PBAC | about a 50-cent coin | ~3.2 cm |
Coins as a size guide: Australian 5-cent ≈ 19 mm · Australian $1 ≈ 25 mm · US quarter ≈ 24 mm · Korean 100-won ≈ 24 mm · Korean 500-won ≈ 27 mm · Australian 50-cent ≈ 32 mm. If you regularly pass clots bigger than a coin, that's worth mentioning to a doctor regardless of which chart you use.
A PBAC score is a clever proxy: a total of about 100 points lines up with the clinical 80 ml heavy-bleeding threshold first established by Hallberg's 1966 population study and used in the FIGO definition of abnormal uterine bleeding. But a score is abstract — "112 points" doesn't mean much on its own.
PeriodVol uses the same pictorial principle, but converts each product straight into an estimated volume in millilitres. You tap the pad, tampon or cup and how soaked it was; PeriodVol shows your blood loss per day and per cycle in ml, marks the 80 ml line, and can generate a doctor report that compares your cycles to the normal FIGO ranges. It's a digital, automatic version of the chart — no points to add up.
Track it automatically with PeriodVolThe PBAC is a paper chart used to estimate menstrual blood loss. Each day you tally the pads and tampons you used and how soaked each one was, plus clots and flooding, then add up the points. It was introduced by Higham, O'Brien and Shaw in 1990 as a simple, non-laboratory way to assess heavy menstrual bleeding.
Yes. This page has a printable day 1–8 tally sheet: one row per item (pads and tampons at three saturation levels, small and large clots, flooding), a column for each day, the point value for each row and a row-total column. Use the "Print this chart" button; only the sheet prints.
Pads score 1 point if lightly stained, 5 if moderately soaked, and 20 if completely saturated. Tampons score 1, 5, and 10 points for lightly, moderately and fully soaked. A small clot is 1 point, a large clot is 5 points, and each episode of flooding is 5 points. You add the daily scores across the whole period.
A PBAC score of 100 or more over a period is generally taken to indicate probable menorrhagia (heavy menstrual bleeding), which corresponds to more than about 80 ml of blood loss per cycle. In the original validation a cut-off of 100 had sensitivity and specificity above 80%, though later studies report a range of cut-offs.
The sheet on this page has eight day columns, which covers most periods. If you bleed for longer, print a second sheet and keep tallying — the score that matters is the total for the whole period, however many days it runs.
Charts define it differently. The Canadian Hemophilia Society's Menstrual Assessment Chart calls a clot larger than 1 cm "large". General clinical guidance often uses "larger than a 2.5 cm (1 inch) coin". The Australian PBAC uses a 50-cent coin (about 3.2 cm) for a large clot and a 5-cent coin for a small one. PeriodVol's app uses a coin about 2.5 cm across as the large-clot guide.
The PBAC turns your logged products into points; a score of 100 roughly maps to the 80 ml heavy-bleeding threshold. PeriodVol uses the same pictorial idea but converts each product directly into an estimated volume in millilitres, so you see an actual ml figure per day and per cycle instead of an abstract score.
Yes. PeriodVol is a free app that works like a digital pictorial chart: you tap the product and how soaked it was, and it estimates your blood loss in millilitres, flags the 80 ml threshold, and can produce a doctor report.
PeriodVol is not a medical device and this page is educational, not medical advice. The scoring and thresholds above are drawn from the clinical literature below.