Correcting Anemia From Heavy Menstrual Bleeding Can Improve QOL

[[{"type":"media","view_mode":"media_crop","fid":"25640","attributes":{"alt":"anemia","class":"media-image media-image-right","id":"media_crop_11557962279","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2377","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; float: right; height: 121px; width: 160px;","title":" ","typeof":"foaf:Image"}}]]After identifying a correlation between anemia and heavy menstrual bleeding, researchers in Finland suggest early iron substitution should be an integral part of treatment.

Although many of the 236 study participants were anemic, most had never taken an iron supplement.

Pertinent Points

- Women with heavy menstrual bleeding should be screened for anemia and iron deficiency.

- Improving iron levels may also improve the quality of life for these women, in particular by reducing anxiety and depression and raising energy levels.

- At the very least, the treatment options of hysterectomy or IUD both correlated with improvements in hemoglobin levels a year after treatment.

The authors of the paper, published in Acta Obstetricia et Gynecologica Scandinavica, conducted a secondary analysis of a randomized controlled trial that looked at women with heavy menstrual bleeding who were treated either with a hysterectomy or an IUD.

What they found was that at baseline, prior to treatment, 63 (27%) of the 236 women were anemic and 140 (60%) were considered severely iron deficient (ferritin level < 15 µg/L). Yet, only 8% of those who were anemic had taken an iron supplement.

Even a year after receiving one of the two treatments for heavy menstrual bleeding, differences in hemoglobin were detected, the authors found. While both treatment groups saw increases in hemoglobin levels, those women who were initially anemic still had significantly lower levels than nonanemic women.

Besides affecting the physical health of these women, the researchers also identified a link between anemia and quality of life. Following treatment, women with anemia at baseline had greater improvement in energy levels and greater reductions in symptoms of anxiety and depression than those who were not initially anemic, the authors reported.

The improvements in quality of life, which were measured a year after treatment with hysterectomy or IUD, led the researchers to believe that treating heavy menstrual bleeding is also associated with a correction of anemia. This finding suggests that clinicians should actively screen for anemia in women with heavy menstrual bleeding and should start patients on iron substitution early to help maximize improvements in quality of life, concluded the study authors.

Among the 60% of women who had severe iron deficiency, the researchers noted that it took until 5 years post-treatment for serum ferritin to reach normal levels.