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Iron supplements, also known as iron salts and iron pills, are a number of iron formulations used to treat and prevent iron deficiency including iron deficiency anemia. [ 11 ] [ 12 ] For prevention they are only recommended in those with poor absorption , heavy menstrual periods , pregnancy , hemodialysis , or a diet low in iron.
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Menstrual bleeding is a common cause of iron deficiency anemia in women of childbearing age. [28] Women with menorrhagia (heavy menstrual periods) are at risk of iron deficiency anemia because they are at higher than normal risk of losing more iron during menstruation than is replaced in their diet. Most women lose about 40 mL of blood per cycle.
Tranexamic acid is sometimes used to treat heavy menstrual bleeding. [17] When taken by mouth it both safely and effectively treats regularly occurring heavy menstrual bleeding and improves quality of life. [4] [24] [25] Another study demonstrated that the dose does not need to be adjusted in females who are between ages 12 and 16. [4]
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A normal menstrual cycle is 21–35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 mL. Heavy menstrual bleeding is defined as total menstrual flow >80ml per cycle, soaking a pad/tampon at least every 2 hours, changing a pad/tampon in the middle of the night, or bleeding lasting for >7 days.
In a 10-year study, the levonorgestrel coil was found to be as effective as oral medicines (tranexamic acid, mefenamic acid, combined oestrogen–progestogen or progesterone alone) for heavy periods; the same proportion of women had not had surgery for heavy bleeding and had similar improvements in their quality of life. [34] [35]