Menstrual Chart and Scoring System
This chart helps women track their bleeding during a menstrual cycle (period) to help determine if they experience heavy menstrual bleeding. A woman may want to consider seeing a healthcare professional if she scores more than 100 points.
Download and print chart
English [PDF – 109 KB, 1 Page, Print Only]
Spanish [PDF – 142 KB, 1 Page, Print Only]
English [PDF – 109 KB, 1 Page, Print Only]
Spanish [PDF – 142 KB, 1 Page, Print Only]
Doctor Visit Preparation Questions
This tool can be used prior to a healthcare visit to help women think of questions that may be helpful when talking to their provider about symptoms, diagnosis, and a treatment plan. It may also help women develop questions specific to their experience.
Download and print chart
English [PDF – 89 KB, 1 Page, Print Only]
Spanish [PDF – 113 KB, 1 Page, Print Only]
English [PDF – 89 KB, 1 Page, Print Only]
Spanish [PDF – 113 KB, 1 Page, Print Only]
Healthcare Diary
This diary helps women prepare for a visit with a healthcare provider, so that they can accurately discuss their health history and current bleeding signs and symptoms.
Download and print chart
English [PDF – 92 KB, 1 Page, Print Only]
Spanish [PDF – 124 KB, 1 Page, Print Only]
English [PDF – 92 KB, 1 Page, Print Only]
Spanish [PDF – 124 KB, 1 Page, Print Only]
Lab Test Log
This tool helps women track the types of laboratory tests ordered by healthcare providers when determining if they have a bleeding disorder.
Download and print chart
English [PDF – 50 KB, 1 Page, Print Only]
English [PDF – 50 KB, 1 Page, Print Only]
Von Willebrand disease
CDC provides fact sheets and other information about von Willebrand Disease, a blood disorder in which the blood does not clot properly.
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