Objective To assess the accuracy of a pictorial blood loss assessment chart (PBAC) as a method for estimating menstrual blood loss in women complaining of heavy periods.

Design A prospective analysis of 103 consecutive women complaining of excessive menstrual blood loss.

Population Women recruited into an on-going study of menstrual blood loss in a large district general hospital.

Main outcome measures Correlation between pictorial assessment of blood loss and actual measured menstrual blood loss.

Results There was poor correlation between observed PBAC score and menstrual blood loss.

Conclusion We have not been able to validate previously published work. The pictorial assessment chart offers no significant improvement in the quality of objective diagnosis in women complaining of menorrhagia.