Iron deficiency anemia with menorrhagia: Ferric carboxymaltose a safer alternative to blood transfusion

Abstract

Background:Menstrual disorder accounts for 5%–10% of the women presenting with iron deficiency anemia (IDA) in the perimenopausal age group. Heavy menstrual bleeding in this age group leads to severe anemia and frequently requires blood transfusion which has its own adverse effects. We today have ferric carboxymaltose (FCM) as a safer alternative to blood transfusion.Objective:The objective of the study is to evaluate the safety and efficacy of FCM in treating anemia in patients of menorrhagia. Thus avoiding blood transfusion.Materials and Methods:It was an open, single arm observational study including 90 women of age more than 30 years with definitive diagnosis of menorrhagia with IDA and hemoglobin (Hb) levels between 4 gm% and 11 gm%. Intravenous FCM (500–1500 mg) was administered, and the improvement in blood indices was assessed after 3 weeks of total dose infusion. Menorrhagia was controlled by medical treatment till Hb improvement was achieved and definitive surgical intervention was done.Result:Most of the women were in the age group of 40–50 years. Blood indices measured pre-FCM and 3 weeks post-FCM showed a mean increase in Hb from 8.33 ± 1.10 to 10.89 ± 1.02 with a statistically significant P < 0.01. There was a statistically significant rise of packed cell volume, serum ferritin, and serum iron in the post-FCM blood levels after 3 weeks. No serious life-threatening adverse events were observed after FCM administration.Conclusion:Intravenous FCM is an effective and a safe treatment option for IDA with a single administration of high dose without serious adverse effects obviating the need for blood transfusion before surgery.

Daily Consumption of Fruits and Vegetables Has Different Correlations With Haemoglobin Levels in Young Women at Karanganyar Regency

“…Menstrual duration in this study was found to have a negative correlation with Hb levels (b = -0.249; 95% CI = -0.49 to -0.007; p <0.05). This finding is in line with the theory that regular menstruation can cause iron loss [23]. Our study supports a previous research study that adolescent girls with menstrual periods ≥5 days have 2.4 higher risk of developing anemia compared to those with the menstrual periods <5 days [15].…”

A study of prevalence of anemia and associated risk factors in pregnant women of tribal community attending antenatal clinic at Trivandrum district, Kerala, India

“…The excessive blood loss during the menstrual period may contribute to iron deficiency anemia (IDA) to the subjects. 23 Our study results are corroborating with the reports by Weldekedan et al 24 It is a known fact there is a relationship between iron deficiency anemia and irregular cycles among the women, but we could not find any association between the irregularity in menstrual cycle with the prevalence of anemia in pregnant ladies of our study population. Study by Sreelekshmi et al also revealed similar results in a study conducted among tribal women at Palakkad district, Kerala.…”

The role of iron repletion in adult iron deficiency anemia and other diseases

“…In premenopausal women, heavy menstrual bleeding (HMB) is a frequently encountered cause for IDA and mild cases may be treated with a trial of oral iron depending on patient tolerability . Total iron absorption with daily oral supplementation is <10 mg/d such that moderate‐to‐severe anemia from HMB will require IV iron to keep up with the losses and achieve rapid and safe resolution of anemia . Men and women presenting with IDA in the absence of known pathology should be evaluated for other causes of blood loss and a gastroenterology referral should be considered.…”

“…13 Total iron absorption with daily oral supplementation is <10 mg/d such that moderate-to-severe anemia from HMB will require IV iron to keep up with the losses and achieve rapid and safe resolution of anemia. [14][15][16] Men and women presenting with IDA in the absence of known pathology should be evaluated for other causes of blood loss and a gastroenterology referral should be considered. If no cause can be identified, alternative inflammatory, absorptive, or genetic etiologies should be considered.…”