Medically verified by Dr. Rashmi Kudesia
Weakness, headache, even shortness of breath. These symptoms are common, but they can indicate a bigger problem: iron deficiency anemia (IDA). Although IDA is sometimes linked to inadequate iron absorption or poor nutrient absorption, most of the time it is caused by blood loss, including heavy menstrual periods.
If you are one of the millions of women who experience a heavy flow called Heavy Uterine Bleeding (HUB), you are no doubt well aware of the cramps that can set in your style. Perhaps you consider it a messy inconvenience – something to go through every month. However, consulting a doctor can help determine if your heavy periods and non-specific symptoms are signs that you may have IDA.
What is IDA?
Having IDA means that there is a lack of iron in your body. Iron is important because it helps make a substance called hemoglobin, which helps red blood cells carry oxygen around the body.
Dr. Cindy Duke, a certified gynecologist, obstetrician, and reproductive endocrinologist at the Nevada Fertility Institute, said when your blood cells don’t have enough oxygen, you could feel tired and short of breath, or your heart racing. She added that this is because “your heart is working harder, trying to pump blood faster to bring oxygen to your cells.”
In addition to these warning bells, weakness, brittle nails, headache, dizziness, lightheadedness, and pale skin are symptoms of IDA. However, because IDA can also be asymptomatic, some women may not experience symptoms.
Diagnosis and treatment of IDA
A health care provider can give you a simple blood test to see if you have IDA or not. “We check the total level of iron in the blood and the blood’s ability to carry iron,” said Duke. “It’s a straightforward test and inexpensive even without insurance.”
Treating IDA is pretty straightforward too. “When it’s severe, we sometimes have sessions of intravenous iron infusions, usually over a period of four to six weeks,” said Dr. Duke. “If it’s moderate to mild iron deficiency, I start patients on an oral version of iron.”
You may need to add iron regularly, especially to make up for the blood loss lost from HUB. While HUB is common – nearly 25 percent of women have HUB – many are unaware that a HUB of six months or more can lead to IDA. “Some women need to stay on iron, especially when they are not getting enough in their diet. Women who are vegan, for example, tend to have low dietary iron intake, so they may need long-term iron supplementation,” Duke said.
How do you know if you have HUB?
There is bleeding, and then bleeding that looks more like a rushing river. In fact, HUB is defined by profuse bleeding or bleeding that lasts longer than seven days. Other symptoms of HUB to look out for include the need to change pads or tampon overnight and passing blood clots that are quarters or larger.
Duke said a good way to measure your bleeding is to see how fast you are cycling through menstrual products: “If you use pads and have to change your pad more than every few hours, it’s too hard.” She added, “I spend a lot of time explaining this to patients because no one really tells you what qualifies as heavy, light, or normal bleeding throughout your childhood.”
About one in four American women is diagnosed with HUB, which leads to a common condition. However, many women with HUB don’t consider it an issue worth mentioning to their health care providers. “I would say that around 40 percent of women with profuse uterine bleeding are very aware of this and complain of profuse bleeding,” says Duke. “But it comes out more often when we go through a patient’s medical history.”
What if HUB is not diagnosed?
While some women view HUB as nothing more than an inconvenience, it is still important to discuss your symptoms with a doctor. Sometimes HUB is caused by hormonal imbalances or growth in the uterus like fibroids that may need treatment.
“Fibroids are very common. Between 50 and 70 percent of women have them. And of that group of women with fibroids, up to a third can have a type of fibroid called submucosal fibroid that causes profuse bleeding,” Duke said.
The importance of expressing yourself
HUB and IDA can be serious if left untreated. While this may not be the kind of thing you chat about with your girlfriends over brunch, there is one place you shouldn’t hesitate to discuss – your healthcare provider’s office.
Duke said some women learn that their heavy periods caused their heavy IDA only after they were hospitalized. One woman, she said, just didn’t realize that her bleeding was abnormal. “She thought it was exactly how it was for her,” said the doctor.
Duke added that health care providers may ask questions about your period that seem intrusive, but your answers will help determine if you have symptoms that need to be addressed. “We have some objective viewpoints – blood pressure, heart rate, things like that. But the rest is just good old-fashioned medicine, which is to sit down and talk to you and let you share what is going on so we can find out what to do next. “
For more information on HUB and IDA, please visit imayhaveida.com.
This resource was created with the assistance of Daiichi Sankyo, Inc.