Heavy Menstrual Blood Loss

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Heavy periods, menorrhagia, is the commonest cause of anaemia and iron deficiency in women of child-bearing age.

Causes of menorrhagia include: uterine fibroids or polyps, use of an IUD (Intrauterine contraceptive Device) blood disorders, endometriosis, imbalance of reproductive hormones as can occasionally happen in teenage years or when approaching the menopause, an underactive thyroid and rarely cancer of the womb.

The importance of menorrhagia to nutritional state is:

• Approximately 10% of menstruating women in the UK have periods that are heavy enough to cause anaemia or mild iron deficiency.  
• Anaemia is present in 8% of women aged 19 to 50 years and a further 8% of this group have laboratory evidence of low iron stores whereas only 8% in total of women aged 50 to 64 years have evidence of anaemia or iron deficiency.
• The loss of iron due to menstruation results in the Lower Reference Nutrient Intake for iron being significantly higher in women of menstruating age (8.0mg per day) compared with younger or older women (4.7mg per day).
• The oral contraceptive pill usually reduces menstrual loss and reduces the risk of anaemia and iron deficiency. 
• If excessive blood loss is not controlled by medical or surgical means then iron supplements may need to be taken on a regular basis.

Prevalence of Anemia in British Women

As can be seen from the above the prevalence of anaemia is greatest between the ages 19-49 years.

Reference:

http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11002

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