Answering in order. (1) Cause: menstrual blood loss plus probable malabsorption — not "iron not working". (2) For heavy bleeding: pelvic/TVS ultrasound for fibroids/adenomyosis/polyps, TSH, prolactin, PT/aPTT and von Willebrand factor antigen + activity with Factor VIII (done when not bleeding). For malabsorption: anti-tTG IgA with total IgA for coeliac disease, H. pylori stool antigen or breath test, stool occult blood, and an upper GI endoscopy with duodenal biopsy — genuinely indicated in your case. Also CBC with peripheral smear, reticulocyte count, HbA2/electrophoresis (your very low MCV makes thalassaemia trait worth excluding), LFT, RFT. (3) Whom to see: start with a gynaecologist for the bleeding and a gastroenterologist for the gut; a haematologist becomes essential if the vWD/coagulation screen is abnormal or anaemia recurs after both are addressed. (4) Treatment: repeat IV iron (ferric carboxymaltose) aiming for ferritin above 100, then maintenance oral iron on alternate days on an empty stomach with vitamin C — alternate-day dosing is absorbed better than daily. B12 182 is best corrected with intramuscular B12 initially if absorption is doubtful. Vitamin D 6.01 is severe: usually 60,000 IU cholecalciferol weekly for 8 weeks then monthly maintenance, with adequate calcium. (5) Prevention: control the periods (tranexamic acid during menses, or a hormonal option such as a progestogen or LNG-IUS if your gynaecologist agrees), treat any coeliac disease or H. pylori found, and recheck Hb and ferritin every 3 months for a year. You are welcome to consult me on Practo with all reports uploaded together so I can lay this out as one sequenced plan, or if travel is possible, see me at Synergy Multispeciality Hospital, Miraj, where gynaecology, endoscopy and IV iron can be arranged together.

Word of caution: with Hb 9.4 do not ignore breathlessness at rest, chest pain, palpitations, fainting or bleeding through more than one pad an hour — those need emergency assessment. Do not take iron on your own indefinitely without ferritin monitoring, and do not take calcium, tea, coffee or antacids within 2 hours of an iron dose as they block absorption. Importantly, if coeliac testing is planned, do NOT start a gluten-free diet beforehand — it will make the test falsely negative.

- Start the above supplements and continue regularly. -Do  Gynaecology consultation on practo  for heavy menstrual bleeding. - Repeat CBC, ferritin and iron profile after 4–6 weeks. - If anaemia persists/recur despite treatment, evaluate for coeliac disease/GI blood loss.

Avoid  tea/coffee and preferably with water or a vitamin-C-rich drink. If you develop severe breathlessness, chest pain, fainting or very heavy bleeding, seek urgent medical care and discuss on practo

Till then make sure you are consuming enough protein and iron.