A scoping review on heavy menstrual bleeding and anemia: A less explored phenomenon

In 2023, the World Health Organization (WHO) recognized heavy menstrual bleeding as one of the risk factors of anemia in "Accelerating anemia reduction: A complex framework for action." Heavy menstrual bleeding (HMB) leads to chronic increased blood loss causing iron deficiency anemia. Current National health programs in India do not address HMB as a risk factor of anemia in women. Owing to the high burden of anemia and emerging recognition of HMB as one of the causes for anemia, there is need to map the existing evidence on the burden, consequences and management of HMB in context of anemia. This scoping review aims to summarize available literature and identifying areas for future research. A literature search was conducted in the databases PubMed, Google Scholar, and Scopus to identify studies published from 2000 to 2024. The search included MeSH and keywords related to "heavy menstrual bleeding," "menorrhagia," "anemia," "iron deficiency anemia," and "management of HMB." Heavy menstrual bleeding is a prevalent health problem of menstruating women, affecting 4-63% of women globally. HMB is significantly associated with iron deficiency anemia. HMB affects the daily life of women with reported work loss of $1692 per women per year. Iron supplementation in therapeutic doses and hormonal contraceptives are the available medical treatment for HMB and associated anemia. The treatment of HMB with hormonal contraceptives have shown significant improvement in blood loss due to HMB and associated anemia. Heavy menstrual bleeding is a significant cause of iron deficiency anemia among women. Anemia Mukt Bharat program needs to address HMB as important cause for anemia and device strategy for the same. Anemia Mukt Bharat include the intervention for HMB prevention, screening, management, and referral.