Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding.

OBJECTIVE There has been increasing recent recognition of the worldwide confusion in the terminology and definitions for abnormalities of menstrual and uterine bleeding. The present review was undertaken to objectively explore some of the origins and current uses of terms for symptoms, signs, and causes of abnormal uterine bleeding and to demonstrate the international lack of uniformity. DESIGN A detailed, but not systematic, search of the huge current and historical literature across the range of menstrual terminology, definitions, and some causes, with an emphasis on "menorrhagia" and "dysfunctional uterine bleeding." SETTING An international collaboration to study ways of reaching worldwide agreement on descriptive terms and definitions for abnormal bleeding. RESULT(S) A large number of synonyms and overlapping terms for heavy menstrual bleeding have been identified, as well as smaller numbers of terms for other symptoms and causes of abnormal uterine bleeding. The origins and meanings of several of these terms have been explored in detail and wide variations in meaning demonstrated. CONCLUSION(S) There is great confusion in the way these terminologies are used and there is an urgent need for international agreement on consistent use of terms and definitions for symptoms, signs, and causes of abnormal uterine bleeding.