The relationship between menorrhagia, iron deficiency, and anaemia in recreationally active females: an exploratory population based screening study

Objectives Iron deficiency, anaemia, and Menorrhagia - or heavy menstrual bleeding (HMB) - are interrelated conditions that are highly prevalent and commonly underrecognized in exercising females of reproductive age. This study utilised a screening tool to identify risk factors and symptoms associated with HMB, iron deficiency, and anaemia in this population. Design An observational, cross sectional survey study was employed. Here, 1042 active females (aged 18–65) completed a comprehensive screening questionnaire and 887 (85 % compliance) provided a fingerprick blood sample for haemoglobin (Hb) concentration measurement. Women that presented as anaemic (defined as a [Hb] < 120 g/L) or deemed to be at risk of iron deficiency (120 < [Hb] < 130 g/L) were asked to complete follow-up blood tests to screen for iron studies. Results Average [Hb] was 134.2 ± 12.1 g/L, with 94 individuals considered anaemic (10.6 %). Of the sample, 104 underwent follow-up blood tests; 51 (~49 %) presented with iron deficiency (defined as ferritin <30 μg/L). Based on survey responses, 274 (30.9 %) participants were determined to have HMB. Those presenting with HMB were younger, exercised fewer hours per week, and were more likely to have a history of iron deficiency or anaemia (all p < 0.05). Participants reporting a history of anaemia or iron deficiency were more likely to have HMB (anaemia: 39.7 %; iron deficiency; 36.9 %; both p < 0.05). Conclusion In this cohort of exercising females of reproductive age, the prevalence of anaemia was 10.6 %. There is a strong association between HMB and a self-reported history of ID and anaemia. Greater awareness of HMB and its relationship with ID and anaemia is needed in this population. Non-invasive screening should be conducted to raise awareness and further understand the associated risk factors and symptomatology.