Getting Evaluated If You Are at Risk
Iron deficiency anemia fromheavy menstrual periodsis very common.
In women of childbearing age, it is the most frequent cause of iron deficiency anemia.
In the U.S., around 4% of women of reproductive age have iron deficiency anemia.
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Black women in the U.S. and women in developing countries have even higher rates.
What Is Iron Deficiency Anemia?
Iron deficiencyis one of the most common causes of anemia.
Iron is an important component ofhemoglobin, the part of your red blood cells that carries oxygen.
So, if there isnt enough iron around, your body cant make enough healthy red blood cells.
If you dont get enough iron in your diet, that can cause iron deficiency and anemia.
Iron deficiency anemia might also be a problem if your body is having trouble absorbing iron for some reason.
Heavy menstrual bleeding can be accompanied by discomfort, low mood, decreased energy, and social embarrassment.
However, this definition is mostly used for research purposes and not in clinical practice.
Clinically, heavy menstrual bleeding is a subjective measure.
Practically speaking, it can be hard to get a sense of whether you have heavy menstrual bleeding.
Some women may lose quite a bit of blood during their menstrual period but not realize it.
Also note the duration and frequency of your cycles.
That way, you’ll have up-to-date information to share with your healthcare provider.
Heavy menstrual bleeding is usually talked about in the context of a broader problem:abnormal uterine bleeding.
Abnormal uterine bleeding can be because of many different medical problems.
When Menstrual Bleeding Is an Emergency
Heavy menstrual bleeding can sometimes be a medical emergency.
If you experience sudden, extremely heavy bleeding, seek urgent medical care.
People who are pregnant should also check in with their clinician if they experience bleeding of any kind.
Diagnosis
Its important to seek medical evaluation if you believe you might have heavy menstrual bleeding.
You might have an underlying medical issue that needs to be addressed.
Heavy menstrual bleeding or other kinds of abnormal uterine bleeding can also be uncomfortable and inconvenient.
Moreover, you might have developed iron deficiency and iron deficiency anemia, which should be treated.
Anemia Diagnosis
Diagnosis of the anemia itself is relatively straightforward.
The CBC may be the only test needed to diagnose iron deficiency anemia.
Other times, people need additional tests related to iron, such as serumferritin.
Iron deficiency is the only issue that causes a low ferritin.
Unfortunately, finding a correct diagnosis sometimes takes a while, and an underlying cause isnt always identified.
Diagnosis includes your medical history, especially your gynecological history.
Youll want to tell your clinician as much as possible about the nature of your menstrual periods.
ensure to tell your clinician about all medications you are taking.
Include any over-the-counter medications and any birth control or hormone therapies.
The medical exam is often important as well.
Typically, this will include a pelvic exam and possibly an ultrasound.
Depending on the context, one might need certain blood tests.
Imaging tests might include:
Treatment
Treatment focuses on addressing the source of the heavy menstrual bleeding.
Medications
For heavy menstrual bleeding without a clear cause, hormone treatments are a mainstay treatment.
Oral contraceptive pills are also often helpful.
These may be the throw in that contain both estrogens and progestins or the throw in containing progestins only.
Both types can help regulate your cycle so that bleeding isnt quite so heavy or prolonged during your period.
Another medication sometimes used is tranexamic acid (Lysteda), which makes your blood clot more easily.
This might be a good option if you are considering trying to become pregnant soon.
However, these last two are not an option for people who would like to have more children.
You may also need to takeiron supplementswhile your body builds back its store of functioning red blood cells.
Depending on the level of anemia present, IV (intravenous) iron infusions may also be recommended.
In either case, this should take care of your iron deficiency anemia gradually.
After treatment, you may need repeat blood tests to confirm your iron deficiency anemia has indeed resolved.
It can take six to eight weeks for a treatment to improve the anemia.
It’s worth getting checked out if you think this may be an issue for you.
Don’t hesitate to bring it up with your clinician.
Short MW, Domagalski JE.Iron deficiency anemia: evaluation and management.Am Fam Physician; 87(2):98-104.
Wouk N, Helton M.Abnormal uterine bleeding in premenopausal women.Am Fam Physician; 99(7):435-443.
2016;12(1):35-43. doi:10.2217/whe.15.80
