Women with iron deficiency or anaemia and heavy menstrual bleeding (HMB) should take some kind of iron supplementation as soon as they are diagnosed, the authors found.
Yet only 8% of the anaemic women in the study being treated for HMB had taken iron supplementation, which was described as a, “major surprise”.
They suggested this might be because clinicians focus solely on treatment of HMB itself and not the diagnosis and treatment of anaemia and iron deficiency.
“Many doctors anticipate that anaemia and iron deficiency will spontaneously correct once HMB is adequately treated. This study indicates that correction may actually take considerable time,” said the Finnish researchers, led by Pirkko Peuranpää.
It also shows that, after HMB treatment, health-related quality of life (HRQoL) increased more in anaemic than in non-anaemic women.
Study details
This latest research was a secondary analysis of another study comparing hysterectomy and levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of HMB.
It involved 236 women, aged 35–49 years, who were referred to hospital for HMB in Finland.
At baseline, 63 women were anaemic and 140 were severely iron deficient. HRQoL was measured by the RAND 36-item health survey.
Twelve months after treatment, the health survey showed that energy, physical functioning and social functioning increased more – while anxiety and depression scores decreased more – in anaemic compared with non-anaemic women.
Iron defence
HMB is a common cause of iron deficiency and iron deficiency anaemia. Monthly iron losses without adequate dietary iron supplementation gradually reduce the body's iron stores, causing iron deficiency.
When iron stores are depleted, haemoglobin production is affected and iron deficiency anaemia develops.
Although anaemia was corrected during the first year after treatment of HMB in most of the women, it took several years to refill the iron stores with normal dietary iron.
Therefore, the authors recommend treating, “all women with anaemia or iron deficiency and HMB with an effective and rapidly assimilated modern iron preparation at initiation of HMB therapy.”
Other studies have reported reduction in physical performance, cognitive function, mood and HRQoL.
However the authors noted that reasons for reduced quality of life among women with HMB are complex and are not explained by anaemia or iron deficiency alone.
Source: Acta Obstetricia et Gynecologica Scandinavica
Doi: 10.1111/aogs.12394
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Authors: Pirkko Peuranpää, Satu Heliövaara-Peippo, Ian Fraser, Jorma Paavonen and Ritva Hurskainen.