Reviewer ’s report  
 
Title: Heavy menstrual bleeding among women aged 18 -50 years living in Beijing, China: 
prevalence, risk factors, and impact on daily life  
 
Version: 0 Date: 09 Apr 2018  
 
Reviewer: Mary Ann Lumsden  
 
Reviewer's report:  
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This is a very interesting paper with some intriguing findings. It describes the perception of 
HMB in Chinese women of reproductive age. I have some minor comments.  
The 80 ml definition for HMB hasn't been used clinically for well over 10 years for the reasons 
included. I would start the Introduction with the NICE definition and then just mention that the 
80 ml definition is only used in studies involving physiologica l mechanisms.  
More discussion of the method of selection needs including in the main paper. The methods may 
be appropriate but it is difficult to be sure from the information given. There is no indication of 
response rate to the invitation and I assume the y went on asking women until 80/ group was 
achieved. However, with informed consent, not all will say yes and so the total asked would be 
useful.  
The assessment of the presence of HMB is very crude and I wonder why the group didn't use 
something a bit more  sophisticated e.g. PBAC for example.  
The age distribution of women with HMB is surprising and younger than the European/ US 
cohorts. I wonder why that is as incidence of fibroids etc rises with age.  
I was surprised to so no relationship with BMI.  
The rela tionship with alcohol consumption and number of abortions is very interesting and I am 
not aware of it being looked at in other studies. I wonder why this should be the case. I think the 
authors might wish to speculate a little on this.  
Are the methods appropriate and well described?  
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No 
 
Does the work include the necessary controls?  
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Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
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Yes 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statis tical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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