Q: Since we cannot measure the amount of menstrual blood flow, then how do we come to a diagnosis of menorrhagia? Is Etamsylate a safe option for the same?

A:It is indeed a good point! Blood loss is very subjective and there is a huge variation in the way women perceive blood loss. Traditionally, normal blood loss during periods is expected to be around 80 ml. One easy way is to do Full blood count (FBC) which will show difference in levels of haemoglobin (Hb) levels. If bleeding during periods is indeed significant, there will be a drop in Hb levels. It is likely that heavy periods may lead to symptoms of anaemia, especially easy fatigability - getting tired easily. If a woman gives history of frequent change of pads and passing blood clots, it may be indicative of menorrhagia. It also has to be put into wider clinical picture to make the diagnosis.

Ethamsylate acts mainly on blood vessels and platelets (blood cells) to reduce the bleeding. It is only symptomatic relief. The underlying condition causing menorrhagia still needs to be addressed.