Heavy Menstruation
Heavy menstrual bleeding can lead to iron deficiency anemia for several reasons. During menstruation, the endometrium is shed along with blood, leading to blood loss and eventual depletion of iron stores in the body.
In addition, heavy bleeding can result in intestinal damage and impairs iron absorption from food. The heavy bleeding can also cause inflammation, which further contributes to microcytic anemia by promoting the release of hepcidin. Hepcidin is a protein that decreases the absorption and release of iron by binding to ferroportin, a protein that transports iron into and out of cells—thereby causing it to be degraded. As a result, less iron is available for use by the body, leading to microcytic anemia.
Heavy menstrual bleeding can also cause microcytic anemia by depleting stores of other nutrients needed for red blood cell production, such as copper and vitamin B12. Copper is required to form hemoglobin, while vitamin B12 is needed for DNA synthesis during erythropoiesis. Deficiencies in either nutrient can lead to microcytic anemia.
Treatment for microcytic anemia caused by heavy menstruation will focus on replenishing stores of iron and other nutrients needed for erythropoiesis. This can be done through dietary modification, supplementation, and blood transfusions.
