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Heavy Periods - Anaemia
I’m a 28-year-old female with recurrent iron-deficiency anemia for several years. My latest tests showed Hb 9.4, MCV 65.84, iron 15.8, transferrin saturation 3.94%, ferritin 7.8 and RDW 17.1%. I’ve needed iron infusions several times, but the anemia keeps returning. My KFT LFT are ok.
I have very heavy periods, especially on day 2, when I sometimes need to change my pad within about 2 hours. I also have fatigue, hair fall, irritability and mood changes.
I’ve had pelvic ultrasounds in the past that did not show anything significant. I was diagnosed with PCOS a few years ago, but no clear cause for the heavy bleeding was found.
Could you please advise:
1. What could be causing the heavy bleeding despite previous normal/insignificant ultrasound findings?
2. Should I repeat a pelvic ultrasound?
3. What treatment options can reduce the bleeding and prevent my iron deficiency from recurring?
I would like to address the cause of the bleeding rather than repeatedly needing iron infusions.
Answers (3)
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Recurrent iron-deficiency anaemia with these numbers (Hb 9.4, MCV 65.84, iron 15.8) in a woman with heavy periods usually means the ongoing menstrual loss is faster than iron can be replaced. Oral iron alone often struggles to keep up in this situation, especially with a low MCV like yours, which points to chronic iron deficiency built up over years.
Next Steps
Please book a gynaecologist consultation to address the heavy periods themselves, not just the anaemia. Options include hormonal management (like a Mirena IUD which reduces bleeding significantly), tranexamic acid during periods, or investigation for a structural cause like fibroids or adenomyosis with an ultrasound. Alongside, an iron infusion (IV iron) may be more effective than oral iron for rapid correction, and your doctor can advise on this.
Health Tips
Please do not treat the anaemia as a stand-alone problem while the periods stay heavy. Iron tablets alone in this pattern rarely bring levels up to normal, and you will keep dropping back.
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Dr. Neha Vashisth
Obstetrician
14 yrs exp
Jaipur
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.