Science

Why menstrual blood works.

A composite sample — peripheral blood, endometrial cells and tissue, immune populations, and cervicovaginal fluid — that arrives every cycle by virtue of biology. Dried Menstrual Samples (DMS) inherit the analytical surface of Dried Blood Spots and add gynecological biology on top.

Biology

What menstrual blood is.

Menstrual effluent is not just blood. It is a biological composite — peripheral blood that has crossed the endometrium, shed endometrial epithelial cells and stromal tissue, immune cells (T cells, NK cells, macrophages), endometrial extracellular matrix, and a contribution of cervicovaginal fluid [1][2]. Proteomic surveys have identified thousands of proteins in menstrual blood, with overlap to and divergence from the plasma proteome [3].

Two properties are clinically distinctive. First, the sample is composite: in the same volume of effluent there is signal from systemic circulation and signal from the gynecological tract. Second, the sample is recurring: a substantial subset of women produce it monthly for decades, without intervention, instrumentation, or behavior change. No other clinical sample combines those two properties.

Menstrual blood as a composite sample type — peripheral blood, endometrial cells, immune populations, cervicovaginal fluid

Sample type

Dried Menstrual Samples — and what we know from Dried Blood Spots.

A Dried Menstrual Sample is menstrual blood collected on a substrate and dried at the point of collection. The drying step is what turns a biologically rich but logistically fragile fluid into a stable, mailable, scalable analytical specimen. The sample type is closest in spirit to a Dried Blood Spot (DBS) — a substrate that has supported clinical analysis since Guthrie and Susi's 1963 application to phenylketonuria newborn screening, and which today underpins national newborn screening programs in most high-income countries [4].

Dried Blood Spots have been continuously developed for sixty years. The literature on DBS as an analytical substrate now spans molecular diagnostics, clinical chemistry, immunology, pharmacokinetics, and population epidemiology [5][6]. The infrastructure that enables this — sample handling SOPs, regulatory frameworks, elution chemistries, automated analyzers — transfers directly to DMS.

Analytical methods that work on dried samples

Below: the analytical methods established on Dried Blood Spots and validated or in active validation on Dried Menstrual Samples. Stability windows are reported for ambient (room-temperature) shipping and storage based on the cited DBS literature.

Analytical method Types of targets Sample stability (room temperature)
Molecular — DNA (PCR, qPCR, NGS) HPV genotyping; STI pathogens (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis); microbiome 16S; germline genotyping Years on dried filter substrates; HPV DNA validated stable on DMS for 30+ days after a –20 °C to +60 °C, 10-day temperature shock [7][5]
Molecular — RNA (RT-PCR, RNA-seq) Viral RNA, mRNA expression panels, micro-RNA Weeks at ambient on DBS substrates with appropriate stabilizer; longer with low-temperature storage [6]
Methylation (epigenetics) DNA methylation patterns; epigenetic age clocks; tissue-of-origin signatures Years on dried substrates — DNA methylation is one of the most stable analytes in the DBS literature [5]
Clinical chemistry HbA1c, lipid panel, vitamin D, electrolytes, iron status 30+ days at ambient; HbA1c specifically validated on Q-Pad-collected DMS at r = 0.96 vs. venous draws [8][9][6]
Immunoassay (proteins, hormones) Reproductive hormones (TSH, AMH, FSH, LH, estradiol); cytokines; antibody titers Weeks at ambient; correlation with venous draws at r > 0.9 across the standard hormonal menu [10]
Proteomics (LC-MS/MS) Menstrual proteome; inflammation, angiogenesis, and tissue-specific protein signatures Weeks to months at ambient on dried substrates; menstrual proteome contains 350+ proteins distinct from peripheral blood [3]
Metabolomics Small molecules, lipidomics, hormone metabolites Days to weeks at ambient (analyte-dependent); cold chain extends shelf life materially

DMS adds a sample-type surface DBS does not have: shed endometrial cells, cervicovaginal fluid, and gynecologic-tract immune populations. Endometrial-derived signal is accessible because the menstrual sample carries the disease-relevant tissue itself.

Publications

What we've published so far.

Selected peer-reviewed work from Qvin's founding scientist Dr. Sara Naseri and collaborators. More publications are forthcoming as ongoing studies report. This list is the foundation; it is not exhaustive.

  1. Naseri S, Lerma K, Blumenthal PD. Comparative Assessment of Serum versus Menstrual Blood for Diagnostic Purposes: A Pilot Study. Journal of Clinical and Laboratory Medicine 4(2), 2019. doi.org/10.16966/2572-9578.130.
  2. Naseri S, Brewster RCL, Blumenthal PD. Novel use of menstrual blood for monitoring glycaemic control in patients with diabetes: a proof-of-concept study. BMJ Sexual & Reproductive Health 48(2):123–127, 2022. doi.org/10.1136/bmjsrh-2021-201211.
  3. Naseri S, Young S, Cruz G, Blumenthal PD. Screening for High-Risk Human Papillomavirus Using Passive, Self-Collected Menstrual Blood. Obstetrics & Gynecology 140(3):470–476, 2022. doi.org/10.1097/AOG.0000000000004904.
  4. Naseri S, Rosenberg-Hasson Y, Maecker HT, Avrutsky MI, Blumenthal PD. A cross-sectional study comparing the inflammatory profile of menstrual effluent vs. peripheral blood. Health Science Reports 6(1):e1038, 2023. doi.org/10.1002/hsr2.1038.
  5. Naseri S, Avrutsky MI, Capati C, Desai K, Alvero R, Blumenthal PD. Concordance of hemoglobin A1c and reproductive hormone levels in menstrual and venous blood. F&S Reports 5(1):33–39, 2024. doi.org/10.1016/j.xfre.2023.11.009.

Independent corroborating work also appears in the literature — for example, an external qualitative study evaluating menstrual-blood-pad self-sampling for HPV screening among ethnic minority women in Denmark (Hald et al., Journal of Racial and Ethnic Health Disparities, 2025; doi.org/10.1007/s40615-024-01963-9).

See Active programs for the institutional studies currently producing the next round of publications.

References

Sources

  1. Bobel C, Winkler IT, Fahs B, Hasson KA, Kissling EA, Roberts T-A, eds. The Palgrave Handbook of Critical Menstruation Studies. Palgrave Macmillan, 2020. link.springer.com.
  2. Meng C-X, Andersson KL, Bentin-Ley U, et al. Endometrial regenerative cells: a novel stem cell population. Journal of Translational Medicine 5:57, 2007. doi.org/10.1186/1479-5876-5-57.
  3. Yang H, Zhou B, Prinz M, Siegel D. Proteomic analysis of menstrual blood. Molecular & Cellular Proteomics 11(10):1024–1035, 2012. doi.org/10.1074/mcp.M112.018390.
  4. Guthrie R, Susi A. A simple phenylalanine method for detecting phenylketonuria in large populations of newborns. Pediatrics 32:338–343, 1963. publications.aap.org.
  5. McDade TW, Williams S, Snodgrass JJ. What a drop can do: dried blood spots as a minimally invasive method for integrating biomarkers into population-based research. Demography 44(4):899–925, 2007. doi.org/10.1353/dem.2007.0038.
  6. Lehmann S, Delaby C, Vialaret J, Ducos J, Hirtz C. Current and future use of "dried blood spot" analyses in clinical chemistry. Clinical Chemistry & Laboratory Medicine 51(10):1897–1909, 2013. doi.org/10.1515/cclm-2013-0228.
  7. U.S. Food & Drug Administration. 510(k) Premarket Notification database — Q-Pad cleared device record and supporting analytical protocols. accessdata.fda.gov.
  8. Naseri S et al. Clinical Validation of Menstrual Blood for the Detection of Hemoglobin A1c and Other Blood-Based Biomarkers. Clinical Chemistry, 2023.
  9. Naseri S et al. Validation of a Menstrual Blood Collection Device for Glycemic Biomarker Analysis. Clinical Chemistry, 2023.
  10. Naseri S, Rosenberg-Hasson Y, Maecker HT, Avrutsky MI, Park CL. Demonstration of menstrual blood as a viable source for screening and diagnostic clinical applications: a pilot study. BMC Women's Health, 2023. bmcwomenshealth.biomedcentral.com.