Sources of Variation in Menstrual Blood Loss

Cole, Susan; Billewicz, W. Z.; Thomson, A. M.

doi:10.1111/j.1471-0528.1971.tb00208.x

Cited by 149 publications

(51 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median menstrual iron loss in European women is approximately 0.45 mg/day, with 75th, 90th, and 95th percentiles of 0.85, 1.35, and 1.75 mg/day, respectively [20][21][22]. As suggested by Hallberg and Rossander-Hultén [23], the menstrual iron losses may be even higher.…”

Section: Discussionmentioning

confidence: 97%

“…The use of oral hormonal contraceptives tends to reduce blood losses [3,21,24,25], whereas IUDs tend to increase the losses [3,21,25,26]. The duration of menstrual bleeding was shortest in pill users and longest in IUD users, while those using other contraceptive methods took an intermediate position.…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude of the blood and iron losses at menstruation appears to be relatively constant in the individual women but displays considerable interindividual variation [20][21][22][23]. The median menstrual iron loss in European women is approximately 0.45 mg/day, with 75th, 90th, and 95th percentiles of 0.85, 1.35, and 1.75 mg/day, respectively [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation

Milman

Clausen

Byg

1998

Annals of Hematology

125

View full text Add to dashboard Cite

The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18-30 years. Iron deficiency (S-ferritin <16 microg/l) was observed in 9.7%, of the women, iron deficiency anemia (S-ferritin < 13 microg/l and Hb < 121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14-20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0%, in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (rs= -0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r(s)= -0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation

Milman

Clausen

Byg

1998

Annals of Hematology

125

View full text Add to dashboard Cite

show abstract

“…To maintain sufficient stores of iron, it is generally recommended that the daily intake (RDI) of dietary iron is 8 mg/ day for adult men, and 18 mg/day for adult women (Food and Nutrition Board, Institute of Medicine, Washington, DC 2001). The higher RDI for women comes as a result of menstrual blood loss, which is estimated to equate to 1.5-2.1 mg/day of iron loss (Cole et al 1971). The body absorbs approximately 6-12% of the total dietary iron consumed daily (Adamson 1999).…”

Section: Iron Metabolismmentioning

confidence: 99%

Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones

Peeling

Dawson

Goodman³

et al. 2008

Eur J Appl Physiol

246

178

View full text Add to dashboard Cite

Iron is utilised by the body for oxygen transport and energy production, and is therefore essential to athletic performance. Commonly, athletes are diagnosed as iron deficient, however, contrasting evidence exists as to the severity of deficiency and the effect on performance. Iron losses can result from a host of mechanisms during exercise such as hemolysis, hematuria, sweating and gastrointestinal bleeding. Additionally, recent research investigating the anemia of inflammation during states of chronic disease has allowed us to draw some comparisons between unhealthy populations and athletes. The acute-phase response is a well-recognised reaction to both exercise and disease. Elevated cytokine levels from such a response have been shown to increase the liver production of the hormone Hepcidin. Hepcidin up-regulation has a negative impact on the iron transport and absorption channels within the body, and may explain a potential new mechanism behind iron deficiency in athletes. This review will attempt to explore the current literature that exits in this new area of iron metabolism and exercise.

show abstract

“…Cole et al [2] suggested that excess menstruation should be considered to be present when more than 80 ml of blood is lost per cycle. However, the initial complaint of menorrhagia is a subjective one and most often originates from the woman's perceived menstrual loss.…”

Section: Introductionmentioning

confidence: 99%

Management of menorrhagia with the levonorgestrel intrauterine system versus endometrial resection

Malak

Shawki

2006

Gynecol Surg

View full text Add to dashboard Cite

Menorrhagia is the presenting symptom among the majority of women who undergo hysterectomy. The levonorgestrel intrauterine system (LNG-IUS) is highly effective in reducing menstrual bleeding. The aim of this randomized study was to compare the effect of endometrial resection (ER) as a surgical modality and the LNG-IUS as a hormonal modality for treating menorrhagia. This is a therapeutic, phase III randomized study that included 60 premenopausal women with excessive uterine bleeding. The patients were randomly allocated to two treatment groups -LNG-IUS or endometrial resection (ER). Uterine bleeding was quantified by the pictorial blood loss assessment score (PBAC). The degree of disturbance caused by menstrual bleeding on general well-being, work performance, physical activity and sexual activity was assessed using a visual analogue scale at screening. Initial evaluation was followed by reassessment at 6 months, and at 12 months or at discontinuation. Both groups were matched for age, duration of flow and uterine characteristics. In the LNG-IUS group, four patients discontinued treatment and, ultimately, treatment success was 77%. In the ER Group, all operations were uneventful. A significant reduction in the amount of blood loss monthly was achieved in 83% of the cases, and there was a significant improvement in the quality of life of the patients in both study groups. The difference between the two groups was not statistically significant (p=0.747). The placement of LNG-IUS has a dramatic effect in lowering bleeding intensity in menorrhagic patients, with the advantage of reversibility, and mild adverse events. It may be the firstline treatment in younger women with menorrhagia.

show abstract

Sources of Variation in Menstrual Blood Loss

Cited by 149 publications

References 13 publications

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation

Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones

Management of menorrhagia with the levonorgestrel intrauterine system versus endometrial resection

Contact Info

Product

Resources

About