Iron deficiency and heavy menstrual bleeding
Heavy menstrual bleeding, or HMB, affects 10-30% of women.1 But how do you know if your periods are particularly heavy? A doctor will typically diagnose HMB when a woman loses more than 80ml of blood during a period. This is tricky to measure, of course, so doctors will also look for other signs. For example, medical guidelines in the UK say that a woman is suffering from HMB if her blood loss is so great it is affecting her quality of life.2
Take a look at the questions below to help you understand whether or not you are suffering from HMB.
Are my periods unusually heavy?
It may be hard to know if your periods are worse or heavier than your friends’and difficult to explain to your doctor what an impact they have on your life. The questions below will help you judge how heavy your periods are, and give you a starting point for a conversation with your doctor.
- Do you need to use double sanitary protection (tampons and towels)?
- Do you sometimes leak through your clothes or on to your bedding?
- Do you need to change your pad/tampon every two hours or more?
- Do you pass large blood clots (more than 1 inch across)?
If you answered yes to two or more of the above questions you may have HMB. Talk to your doctor as they may be able to offer you treatment to ease some of these symptoms. If you are losing a lot of blood with your periods you are at risk of iron deficiency. Check the signs below and also discuss this with your doctor. Even if you don’t think you have HMB you may still have trouble replacing the iron lost during your period. Iron deficiency is common in women and can have an impact on your general health.
Signs of iron deficiency
You may have already been diagnosed with HMB and be receiving treatment. However, if you are still experiencing extreme tiredness or you don’t generally feel better in between your periods, you might be experiencing fatigue, which could be due to iron deficiency.You may have already been diagnosed with HMB and be receiving treatment. However, if you are still experiencing extreme tiredness or you don’t generally feel better in between your periods, you might be experiencing fatigue, which could be due to iron deficiency. 3 You can use our Fatigue Survey to assess your level of tiredness, and you can use the results to help explain to your doctor how it is affecting your life. Other signs of iron deficiency and/or iron deficiency anaemia include looking pale4 and losing concentration easily.5 To find out more about the signs and symptoms of iron deficiency see our Symptom Browser.
I may have iron deficiency, what can I do?
Periods become such a part of life that you may not think to talk to your doctor about them. You may feel that although they are very heavy, you need to just get on with it. But if your periods are impacting on your life, whether they are heavy or not, you should seek advice. Don’t forget you can ask to see a female doctor, or you may feel more comfortable talking to a nurse at first.
Remember, periods are just a part of life, don’t let them take over.
- 1. Liu Z, Doan Q V, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-94. doi:10.1111/j.1524-4733.2007.00168.x.
- 2. National Institute for Health and Clinical Excellence.Heavy menstrual bleeding. Natl Clin Guidel 44. 2007;(January):4 - 30.
- 3. Peyrin-Biroulet L, Williet N, Cacoub P.Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review. Am J Clin Nutr. 2015;102(6):1585-94. doi:10.3945/ajcn.114.103366.
- 4. Stoltzfus R, Edward-Raj A.Clinical pallor is useful to detect severe anemia in populations where anemia is prevalent and severe. J Nutr. 1999;129(May):1675-1681. Available at: http://jn.nutrition.org/content/129/9/1675.short. Accessed February 11, 2014.
- 5. Koduru P, Abraham BP.The role of ferric carboxymaltose in the treatment of iron deficiency anemia in patients with gastrointestinal disease. Therap Adv Gastroenterol. 2016;9(1):76-85. doi:10.1177/1756283X15616577.