Heavy Menstrual Bleeding and Iron Deficiency | Breaking the Vicious Cycle
Heavy menstrual bleeding (HMB) is a common cause of chronic iron loss and iron deficiency, which may be symptomatic even when haemoglobin level is normal. Ferritin testing is essential and assessment of HMB should include quality of life and underlying causes, rather than only blood loss estimates. Investigations should be guided by symptoms, examination findings and risk factors. Management of HMB must both restore iron stores and reduce ongoing menstrual blood loss to prevent recurrence. Of the medical treatment options for blood loss, the 52mg levonorgestrel intrauterine device offers the greatest reduction. Early recognition of low iron levels, plus treatment of both iron stores and menstrual blood loss, helps prevent recurrence and improves wellbeing.
