PeriodVol
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How PeriodVol estimates menstrual blood loss

Every millilitre value in the app, the published research behind them, and a plain account of what this method cannot tell you.

The short version. PeriodVol converts the products you log into an estimate of blood lost, in millilitres, and compares your cycle total to the clinical 80 ml heavy-bleeding threshold. Those millilitre values are anchored to published research, not measured on you. PeriodVol is not a medical device, it does not diagnose anything, and it is not clinically validated. This page exists so you can judge the numbers yourself instead of taking our word for them.

1. What the app actually does

Three steps, all of them on your own phone:

  1. You log each menstrual product as you change it — by type (liner, regular, large or night pad, tampon, menstrual cup) and by saturation (Light / Medium / Heavy / Saturated, or a cup fill of ¼ / ½ / ¾ / Full).
  2. Each combination maps to an estimated millilitre value of blood — not total fluid, and not the product's maximum capacity.
  3. Those values are summed across the cycle and compared to the 80 ml threshold for heavy menstrual bleeding (HMB).

There is no account and no server. Nothing is transmitted, so none of this is calculated anywhere except on your device.

2. What this method can and cannot tell you

Worth being direct about, because it determines how much weight the number deserves.

An estimate that is honest about being an estimate is still far more useful than a shrug — which is the situation this app was built to fix. But it is an estimate.

3. Where the 80 ml threshold comes from

The upper limit of normal menstrual blood loss is 80 ml per cycle. It comes from the foundational population study:

Hallberg L, Högdahl A-M, Nilsson L, Rybo G. Menstrual blood loss — a population study. Acta Obstetricia et Gynecologica Scandinavica, 1966;45(3):320–351.

That 80 ml figure is still the objective research definition of HMB, and it is what PeriodVol flags. Modern guidelines such as NICE NG88 additionally define HMB by its impact on quality of life — a person can be seriously affected below 80 ml. PeriodVol surfaces the objective number and leaves the diagnosis to a clinician.

Normal menstrual parameters (FIGO 2018)

The doctor report compares your logs against the four parameters FIGO defines, so volume is presented inside the vocabulary clinicians already use for abnormal uterine bleeding rather than as an isolated number.

Munro et al., FIGO 2018
ParameterNormal rangeAbnormal
Frequencyevery 24–38 days< 24 or > 38 days
Duration≤ 8 days> 8 days (prolonged)
Regularityshortest–longest ≤ 7–9 daysgreater variation
Volume5–80 ml per cycle> 80 ml (heavy)

Relationship to the PBAC

PeriodVol's picture-based saturation logging follows the same principle as the Pictorial Blood Loss Assessment Chart (PBAC), a validated clinical tool in which products are recorded by saturation level and clots, and the resulting score estimates blood loss (Higham 1990). A PBAC score of 100 or more correlates with measured loss over 80 ml, with sensitivity and specificity above 80% in the original validation, though later studies report varying cut-offs.

PeriodVol differs by mapping each logged item straight to estimated millilitres rather than to arbitrary points — but the underlying pictorial-to-volume logic is the same evidence-based approach. You can score yourself the classic way with our PBAC calculator.

Where PeriodVol sits among pictorial methods

The pictorial family splits in two:

PeriodVol's model belongs with the millilitre-calibrated group. Like Wyatt and Magnay it reports estimated volume rather than abstract points, and its per-product values track the Wyatt 2001 figures closely — the night-pad scale is close to Wyatt's night-towel scale — while staying at the conservative, real-use end relative to the high-absorbency “ultra” products measured by Magnay 2014 and DeLoughery 2024. The doctor report also surfaces a PBAC-equivalent point score, so the output is legible to a clinician who thinks in either unit.

4. The per-product values

These are the estimated millilitres of blood per single product change, at each saturation level. They are exactly the values the app computes with — the code is the source of truth, and these tables are generated from it.

Pads — ml per change

Pad sizeLightMediumHeavySaturated
Liner0.51.01.52
Regular1.02.54.05
Large2.04.07.010
Night3.06.010.014

Tampons — ml per change

 LightMediumHeavySaturated
Tampon1357

Menstrual cups — ml per emptying

Cups are marked with volume lines, so this is the most accurate input in the app: stated capacity × observed fill.

Cup capacity¼½¾Full
20 ml5101520
25 ml6131925
30 ml8152330

Not sure of your cup's capacity? See our menstrual cup capacity guide.

Clots

 Small clotLarge clot
Estimated volume1 ml3 ml

Clots contribute a small millilitre estimate, but the app also surfaces clot size and frequency separately, because large or frequent clots are an independent clinical signal regardless of the total volume. Our blood-loss chart guide covers how clot size is judged.

5. Why the numbers are lower than you might expect

This is the single most important design decision in the app, and the one most worth understanding before you trust a total.

PeriodVol estimates the blood actually lost in typical use, which is deliberately lower than a product's maximum laboratory capacity.

The anchor rule: a fully soaked regular pad or tampon ≈ 5 ml of blood, so it takes roughly 16 fully soaked normal products to reach 80 ml. That comes from the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) at the University of British Columbia, whose guidance puts a soaked normal product at about 5 ml and a super or maxi product at about 10 ml. That independently corroborates two of our values — the 5 ml regular-saturated anchor and the 10 ml large-pad-saturated estimate — and keeps cycle totals inside the physiologically realistic 30–80 ml range Hallberg established.

Why not use measured maximum capacity?

In 2023 a study tested real products with blood for the first time:

DeLoughery E, Colwill AC, Edelman A, Samuelson Bannow B. Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding. BMJ Sexual & Reproductive Health, 2024;50(1):21–26.

It found modern products often hold far more than their labels suggest, with wide variation between them. But those are maximum saturation capacities — how much a product can hold when soaked to its limit — which is not how much blood is typically lost in one change.

We got this wrong ourselves. An earlier version of PeriodVol's model used maximum-capacity figures as if they were typical per-use loss, which overestimated real blood loss by roughly 3–6×. We corrected the values downwards on 17 June 2026. If you used the app before that date, your older cycle totals read higher than the current model would produce.

The net effect is that PeriodVol is tuned not to cry wolf. It is deliberately conservative about flagging heavy bleeding, so that an 80 ml flag means something instead of firing every cycle.

6. A worked example

One cycle, logged:

Cycle total ≈ 54 ml → “Normal” — below the 80 ml line, above the 30–40 ml average. The app also shows the number of changes (14) and clots (1) as secondary signals, so the total is never the only thing you see.

7. Which inputs are most reliable

  1. Menstrual cup — a direct volume reading. Highest accuracy by a clear margin.
  2. Pad and tampon saturation — estimated, and dependent on you judging Light through Saturated consistently. This is the main source of variation between users.
  3. Clots — counted, contributing a small fixed volume plus a separate qualitative flag.

The app limits the damage any one judgement can do by showing pictograms for each saturation level, and by surfacing the number of changes and the clot burden alongside the millilitre total, so no single estimate dominates the picture.

8. Known limitations

9. Regulatory and safety positioning

10. What would make this validated

To move from “literature-anchored estimate” to “validated”, the credible steps would be:

  1. A prospective study comparing PeriodVol's per-use estimates and cycle totals against the alkaline-haematin reference method, or a validated pictogram, in real users.
  2. Reporting sensitivity and specificity of the 80 ml flag against measured loss.
  3. Independent review, and — if a diagnostic claim were ever intended — the appropriate medical-device regulatory pathway for that market.

None of that has been done. Until it is, PeriodVol is an evidence-anchored estimator, and we will keep describing it that way.

Frequently asked questions

How does PeriodVol estimate blood loss in millilitres?

You log each product by type and how soaked it is; each combination maps to an estimated millilitre value, summed across the cycle and compared to 80 ml. It all runs on your device.

Is PeriodVol clinically validated?

No. The figures are literature-anchored estimates, not measurements validated against the alkaline-haematin reference method in real users. It is not a medical device and does not diagnose.

Where does the 80 ml threshold come from?

Hallberg et al. 1966 — 476 women, blood loss measured by alkaline haematin. The mean was 30–40 ml and roughly 80 ml sat at the 95th percentile, so it became the upper limit of normal.

How much blood does a fully soaked pad or tampon hold?

PeriodVol uses ~5 ml for a soaked regular pad or tampon and ~10 ml for a soaked large pad, so ~16 soaked normal products ≈ 80 ml. These are typical-use estimates, not laboratory maximums.

Why did PeriodVol lower its millilitre values?

The earlier model used maximum product capacity as if it were typical per-use loss, overestimating by roughly 3–6×. It was corrected downwards on 17 June 2026 so that an 80 ml flag stays meaningful.

How accurate is estimating from pads and tampons?

A cup is the most accurate input because you read the volume directly. Pad and tampon saturation is subjective and is the main source of variation between users, which is why changes and clots are shown alongside the total.

References

  1. Hallberg L, Högdahl A-M, Nilsson L, Rybo G. Menstrual blood loss — a population study. Acta Obstet Gynecol Scand. 1966;45(3):320–351.
  2. DeLoughery E, Colwill AC, Edelman A, Samuelson Bannow B. Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding. BMJ Sex Reprod Health. 2024;50(1):21–26.
  3. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE guideline NG88, 2018 (updated 2020). Defines HMB clinically by impact on quality of life; 80 ml is the objective definition.
  4. Centre for Menstrual Cycle and Ovulation Research (CeMCOR), University of British Columbia. Very Heavy Menstrual Flow. Practical anchor: soaked normal product ≈ 5 ml, super/maxi ≈ 10 ml, > 80 ml ≈ 16 soaked normal products.
  5. Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding: 2018 revisions. Int J Gynecol Obstet. 2018;143(3):393–408.
  6. Higham JM, O'Brien PMS, Shaw RW. Assessment of menstrual blood loss using a pictorial chart. Br J Obstet Gynaecol. 1990;97(8):734–739. The validated PBAC.
  7. Janssen CAH, Scholten PC, Heintz APM. A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss. Obstet Gynecol. 1995;85(6):977–982.
  8. Barr F, Brabin L, Agbaje O. A pictorial chart for managing common menstrual disorders in Nigerian adolescents. Int J Gynaecol Obstet. 1999;66(1):51–53.
  9. Wyatt KM, Dimmock PW, Walker TJ, O'Brien PMS. Determination of total menstrual blood loss. Fertil Steril. 2001;76(1):125–131. Millilitre-calibrated pictogram validated against alkaline haematin.
  10. Magnay JL, Nevatte TM, Seitz C, O'Brien S. A new menstrual pictogram for use with feminine products that contain superabsorbent polymers. Fertil Steril. 2014;101(2):515–522.
  11. Magnay JL, O'Brien S, Gerlinger C, Seitz C. Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review. BMC Womens Health. 2020;20:24.
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PeriodVol — privacy-first menstrual volume & colour tracker. Millilitre figures are estimates and this is not a medical device. It does not diagnose, treat or prevent any condition; always talk to a healthcare professional about your health.
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