Anemia From Heavy Menstrual Bleeding

Approximately 10 to 15 percent of women experience heavy menstrual bleeding and of these women, 20 percent will develop anemia, according to the National Anemia Action Council. During a normal menstrual period, you will lose about two to three tablespoons of blood. If you are losing five or six or more tablespoons of blood, you are experiencing heavy menstrual bleeding, or menorrhagia. This extra blood loss may cause iron deficiency anemia, a condition characterized by too little iron in the blood reducing how many red blood cells you have.

What Causes Heavy Menstrual Bleeding?

In some cases, your doctor will not be able to find a cause. Uterine fibroids, endometriosis, certain medications, ovarian dysfunction, an intrauterine device or a hormonal imbalance may cause heavy menstrual bleeding. Other possible causes include polyps, pregnancy complications, adenomyosis, inherited bleeding disorders, pelvic inflammatory disease, cancer, thyroid disorders and kidney or liver disease.

Signs and Symptoms of Iron Deficiency Anemia

If you develop iron deficiency anemia because of heavy menstrual bleeding, there are signs and symptoms you may experience. However, if your deficiency is mild, you may have no symptoms. Signs and symptoms may include whites of eyes being bluish, reduced appetite, headache, paleness, sore tongue, weakness, brittle nails, fatigue, irritability, shortness of breath and unusual food cravings.

How Will My Doctor Diagnose Iron Deficiency Anemia?

Your doctor will likely perform one or more blood tests to determine if your heavy menstrual bleeding has caused iron deficiency anemia. These blood tests may include fecal occult blood test, iron binding capacity in blood, serum ferritin, hemoglobin and hematocrit, RBC indices and serum iron level.

How is Iron Deficiency Anemia Treated?

Oral iron supplements known as ferrous sulfate are very commonly used to treat a deficiency. These should be taken on an empty stomach for best absorption, but can be taken with food if not tolerated on an empty stomach. If you absolutely cannot tolerate any oral iron supplements, your doctor will likely recommend an intramuscular injection or an intravenous dose.

You should not take any antacids or milk at the same time as iron supplements because these may interfere with the absorption of iron. Vitamin C is necessary for hemoglobin production and can increase absorption.

In addition to supplements, there are several foods that are rich in iron too. These include eggs (the yolks), legumes, poultry, whole-grain bread, fish, meats and raisins.

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Resources

National Anemia Action Council: Women and Anemia: Heavy Menstrual Bleeding and Fibroids