Pictorial blood loss assessment chart (PBAC) for menstrual blood loss

The PBAC is a semiquantitative tool for assessing menstrual blood loss. The patient is instructed to make a mark in the appropriate box when the sanitary pad or tampon is discarded. The points are totaled for the entire menstrual period. A total score of ≥100 has been correlated with heavy menstrual bleeding in adult females. Although one observational study correlated PBAC scores with adolescents' self-report of "heavy," "moderate" (normal), and "light" menstrual flow^[1], additional studies are necessary to confirm the findings and determine appropriate cutoff values for adolescents. Refer to UpToDate content on abnormal uterine bleeding in adolescents for additional information.