Figure 4.

The modern effect of menstruation

Previously, women experienced menstruation approximately 40 times in their lifetime, owing to pregnancy and lactational amenorrhea. Women may now expect to have more than 400 episodes of menstruation, mainly as a result of fertility management. Therefore, AUB is increasingly common. Women may experience significant anemia resulting in a poor physical quality of life. A negative financial effect occurs because of the cost of managing their blood loss and an inability to work outside the home. These costs, alongside a loss of caring ability, will have a negative effect on the wider family. The cost to society through loss of work days and healthcare costs is significant.

AUB, abnormal uterine bleeding.

Critchley. Menstruation: science and society. Am J Obstet Gynecol 2020.