Abnormal vaginal bleeding secondary to iron deficiency in a thirteen year old

Abnormal vaginal bleeding in perimenarchal females is usually attributed to immaturity of the hypothalmic/pituitary/gonadal axis (i.e., dysfunctional uterine bleeding). Iron deficiency as a cause for abnormal bleeding has been described, but is poorly understood. This case report describes a 13-year-old Hispanic female with iron deficiency anemia as a presumptive cause for two episodes of abnormal vaginal bleeding. Anemia may be a cause as well as an effect of menorrhagia in young teenagers. Work-up should include evaluation of tissue iron stores if other etiologies for abnormal bleeding are not found.