Higham score calculator for menstrual blood loss

The Higham score is based on a multi-day scorecard including the menstrual period. A printout can be given to the patient by following the following link and printing the grid on a full page:
download menstruation evaluation grid

Total number of tampons or towels...
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Total number of clots...


Score :

What is the Higham Score?

The Higham Score is a simple and effective tool designed to measure menstrual blood loss. It is widely used in gynecology to assess whether a person is experiencing heavy menstrual bleeding (HMB), also known as menorrhagia. The scoring system is based on tracking the number of sanitary products used (tampons or pads) during menstruation and categorizing them by how soaked they are. Additionally, it takes into account the presence and size of blood clots.

This score provides a quantitative way to estimate menstrual flow, as self-reporting can often be subjective. By assigning numerical values to different levels of blood absorption, the Higham Score allows for a standardized assessment that helps both patients and healthcare providers better understand menstrual blood loss patterns.

Why is it used?

The Higham Score is used primarily to identify and evaluate cases of heavy menstrual bleeding, which can be a sign of underlying health conditions such as hormonal imbalances, fibroids, polyps, or bleeding disorders. Many individuals may not realize that their menstrual flow is abnormally heavy, and this tool helps in objectively determining if medical intervention is needed.

Doctors and gynecologists use the Higham Score to:

  • Assess the severity of menstrual bleeding over multiple cycles.
  • Diagnose conditions such as menorrhagia and other menstrual disorders.
  • Monitor the effectiveness of treatments, such as medication or surgical interventions.
  • Help in deciding whether additional medical tests (e.g., ultrasound, blood tests) are necessary.

Heavy menstrual bleeding can significantly impact daily life, leading to fatigue, anemia, and discomfort. By tracking the Higham Score over time, individuals can gain better insight into their menstrual health and seek medical advice when necessary. If the score is consistently high, it may indicate an underlying issue that requires medical evaluation.

Using the Higham Score along with a menstrual diary can help in discussing symptoms with healthcare providers, ensuring a more accurate diagnosis and an appropriate treatment plan. Regular monitoring and early detection can prevent complications and improve overall well-being.

How to Use the Calculator

The Higham Score Calculator is designed to help individuals track their menstrual blood loss by entering data about tampon and towel usage, as well as the presence of blood clots. Follow these steps to accurately calculate your score.

Inputting Tampon and Towel Usage

To record the number of tampons and towels used during your period, follow these guidelines:

  • Slightly soaked: Enter the number of tampons or pads that are only lightly stained with blood.
  • Moderately soaked: Record the number of tampons or pads that have absorbed a moderate amount of blood but are not fully saturated.
  • Very soaked: Input the count of tampons or pads that are fully saturated with blood.

These entries help quantify the total blood loss by assigning a numerical value to each level of absorption.

Recording Clots

In addition to tampon and towel usage, the presence and size of blood clots should be noted:

  • Small clots (<1 cm): Enter the number of small clots observed during menstruation.
  • Large clots (≥1 cm): Record the number of larger blood clots, as they may indicate heavier blood loss.

Clot size and frequency can provide important insights into the overall volume of blood loss.

Calculating the Score

Once all inputs have been entered, click the Calculate button. The Higham Score is determined using the following formula:

  • Slightly soaked tampon/pad: 1 point each
  • Moderately soaked tampon/pad: 5 points each
  • Very soaked tampon: 10 points each
  • Very soaked towel: 20 points each
  • Small clots (<1 cm): 1 point each
  • Large clots (≥1 cm): 5 points each

The total score is then displayed, allowing users to assess their menstrual blood loss. A higher score may indicate heavy menstrual bleeding (HMB) and could be a sign to seek medical advice.

For better tracking, it is recommended to use the Menstrual Evaluation Grid to record your daily menstrual flow and calculate the score accurately.

Understanding the Results

After using the Higham Score Calculator, your total score will indicate the level of menstrual blood loss. This section explains how to interpret your results and when to seek medical advice.

What Does Your Score Mean?

The Higham Score provides a numerical value to assess menstrual blood loss. Here’s what your score may indicate:

  • 0 – 24: Normal menstrual blood loss, typically considered within a healthy range.
  • 25 – 50: Slightly heavier than average but may still be normal for some individuals.
  • 50 – 100: Moderate to heavy menstrual bleeding; it may be worth monitoring over multiple cycles.
  • 100+: Considered excessive menstrual bleeding (menorrhagia), which may require medical attention.

It is important to track your score over several cycles to identify patterns and determine if your bleeding is consistently heavy.

When to Seek Medical Advice

While some variation in menstrual flow is normal, persistent heavy bleeding may indicate an underlying medical condition. You should consult a healthcare professional if you experience:

  • A Higham Score consistently above 100.
  • Bleeding that lasts more than 7 days.
  • The need to change tampons or pads every hour due to excessive soaking.
  • Passing large blood clots (greater than 1 cm) frequently.
  • Symptoms of anemia, such as fatigue, dizziness, or shortness of breath.
  • Menstrual bleeding that disrupts daily activities and quality of life.

Heavy menstrual bleeding can be caused by various conditions, including hormonal imbalances, fibroids, polyps, or bleeding disorders. Early detection and proper management can help prevent complications and improve overall well-being.

If you are concerned about your menstrual blood loss, keep a record of your Higham Score and share it with your doctor to facilitate a more accurate diagnosis and treatment plan.

Frequently Asked Questions (FAQs)

1. Can my Higham Score vary each cycle?

Yes, menstrual blood loss can fluctuate from cycle to cycle due to factors like stress, diet, hormonal changes, or underlying health conditions. Tracking your score over several months helps identify patterns and detect any concerning trends.

2. What if I don’t use tampons or towels?

If you use alternative menstrual products like menstrual cups or period underwear, the Higham Score may not be as accurate for your situation. However, you can still estimate blood loss by noting how frequently you need to empty your menstrual cup or change your underwear, and discuss this with a healthcare provider.

3. How accurate is the Higham Score?

While the Higham Score is a useful screening tool for assessing menstrual blood loss, it is not a definitive medical test. It provides an estimate rather than an exact measurement and should be used alongside other evaluations, such as blood tests or ultrasound scans, if necessary.

4. What is considered a high score?

A score above 100 is generally considered to indicate heavy menstrual bleeding (menorrhagia). If you consistently score over 100 or experience additional symptoms like fatigue or anemia, it is advisable to seek medical advice.

5. Can this score help diagnose medical conditions?

The Higham Score is not a diagnostic tool but rather a way to quantify menstrual blood loss. If your score is high, your doctor may perform additional tests to diagnose conditions such as fibroids, polyps, endometriosis, or bleeding disorders.

6. How can I lower my score if I have heavy menstrual bleeding?

If your Higham Score indicates heavy bleeding, speak to a healthcare provider. Depending on the cause, treatments may include dietary changes, iron supplements, hormonal therapy (such as birth control pills), or medical procedures to reduce excessive bleeding.

7. Should I track my Higham Score every cycle?

Yes, tracking your score over multiple cycles can help detect trends and provide valuable information for medical consultations. Keeping a record of your menstrual flow can also assist doctors in recommending the best course of treatment.

8. Does a high score always mean I need medical treatment?

Not necessarily. Some people naturally have heavier periods without an underlying condition. However, if heavy bleeding affects your daily life, causes fatigue, or leads to anemia, medical evaluation is recommended.

9. Can lifestyle factors influence my score?

Yes, lifestyle factors like diet, exercise, and stress levels can affect menstrual flow. Certain medications, such as blood thinners, may also contribute to increased bleeding. Keeping track of lifestyle changes alongside your Higham Score can provide additional insights.

10. What should I do if my score suddenly increases?

If you notice a sudden and significant increase in your Higham Score, it may indicate a new or worsening condition. Consult a healthcare provider to rule out potential causes and discuss appropriate management options.

References

  • Fraser, I. S., Critchley, H. O., & Munro, M. G. (2007). A Practical Guide to Heavy Menstrual Bleeding. Cambridge University Press.
  • Bickley, L. S. (2020). Bates’ Guide to Physical Examination and History Taking (13th ed.). Wolters Kluwer.
  • Dewhurst, J. (2020). Dewhurst's Textbook of Obstetrics & Gynaecology (9th ed.). Wiley-Blackwell.
  • Lobo, R. A., Gershenson, D. M., Lentz, G. M., & Valea, F. A. (2021). Comprehensive Gynecology (8th ed.). Elsevier.
  • Munro, M. G., & Critchley, H. O. (2018). Abnormal Uterine Bleeding in Reproductive-Age Women: Definitions, Diagnosis, and Treatment. Springer.

Disclaimer

The Higham Score Calculator is a useful tool for assessing menstrual blood loss and identifying potential cases of heavy menstrual bleeding (HMB), also known as menorrhagia. However, this calculator is intended for informational purposes only and should not replace professional medical advice, diagnosis, or treatment.

  • Results from this calculator provide an estimate of menstrual blood loss based on tampon and towel usage, as well as the presence of blood clots. These results should be interpreted within the context of the patient's overall clinical condition.
  • Although the Higham Score is a helpful screening tool, it cannot diagnose the underlying causes of heavy menstrual bleeding. A healthcare provider may need to perform additional diagnostic tests (such as ultrasounds or blood tests) to identify the cause of abnormal bleeding.
  • For individuals with consistently high scores (above 100) or symptoms of anemia, fatigue, or significant blood loss, it is essential to seek immediate medical consultation. Early detection and management of underlying conditions are crucial for overall health.
  • Keep a record of your menstrual patterns and consult with your healthcare provider to discuss potential treatment options if your Higham Score indicates heavy bleeding.

If you are concerned about your menstrual health, it is always recommended to seek personalized advice from a qualified healthcare provider.