The management of iron deficiency in menometrorrhagia

Iron-deficiency anaemia, the condition in which anaemia occurs due to a lack of iron, develops when the amount of available iron is insufficient to support normal red blood cell production. Iron deficiency and iron-deficiency anaemia, very prevalent conditions in premenopausal women, are often associated with menometrorrhagia (present in more than two-thirds of cases of iron-deficiency anaemia in premenopausal women). Appropriate identification and treatment of iron deficiency is imperative as iron deficiency can induce important specific clinical manifestations (including fatigue, atrophic changes in the epithelium, oral lesions, dysphagia, nail lesions, reduced immune response). Iron supplementation is the most common strategy used to control iron deficiency. Based on World Health Organisation recommendations, the most appropriate treatment is with an oral ferrous salt in a prolonged-release tablet form, to provide a dose of elemental iron equivalent to 60 mg per intake, in the range of 60 and 120 mg/day according to the severity of iron-deficiency anaemia. When haemoglobin levels have returned to normal, treatment should continue for about 3 months to fill iron stores. An extended-release formulation of ferrous sulphate with mucoproteose has been shown to be associated with a lower incidence of gastrointestinal adverse effects compared with other ferrous and ferric salts.