Fibroids May Put Women at Risk for Anemia
By Alicia Armeli

anemia

Uterine fibroids are a common gynecological condition affecting 20 to 80 percent of women by age 50.1  Of the symptoms associated with fibroids, heavy menstrual bleeding can be one of the most troublesome.

And although considered inconvenient to say the least, heavy bleeding could unknowingly put a woman at danger for much more—like iron deficiency anemia and other related health problems.

According to the American College of Obstetricians and Gynecologists, abnormal uterine bleeding can be described as bleeding that occurs between periods, after sex, beyond menopause, and that can be characterized as heavier or longer than normal.2 Menstrual cycles that are longer than 35 days or shorter than 21 days are considered abnormal.

Although there are several reasons for abnormal bleeding, fibroids and their location within the uterus are important factors to consider. Submucosal fibroids, those that grow within the uterine cavity, may upset normal bleeding by pushing against the uterine lining and vessels supplying blood to the uterus.3,4  Intramural fibroids grow in the uterine wall and can change the shape of the uterine cavity, creating a bigger surface area and more lining to shed each month.  What’s more, intramural fibroids can limit the uterus’ ability to contract. Without normal contractions, blood flow to the uterine lining may be compromised and result in heavier than normal bleeding.3

Excessive blood loss during periods can have dangerous consequences like anemia—a serious health condition in which there aren’t enough red blood cells to carry oxygen to your tissues. Anemia-related complications include weakness, dizziness, fatigue, heart failure, and stroke.5,6

A study by Nelson and Ritchie published earlier this year in the American Journal of Obstetrics and Gynecology looked at 149 women treated at Harbor-UCLA Medical Center between 2008 and 2013 with low hemoglobin levels below 5 g/dL (normal range is 12.1 – 15.1 g/dL) attributed to heavy menstrual bleeding.7 Over 90 percent of the women reported heavy bleeding to be a common occurrence with two-thirds admitting not seeking medical help—even though they bled excessively for more than 6 months.

As a result, nearly 25 percent were producing high levels of platelets—a serious condition that could lead to abnormal blood clotting8 and an increased risk of heart attack, stroke, and other complications. The authors of the study found almost 50 percent of cases were due to uterine fibroids and a staggering near 30 percent were discharged without any instruction to prevent future bleeding.

“Even when faced with potentially life-threatening anemia because of chronic, excessive menstrual blood loss, some women are not impressed with the serious nature of their problem,” Nelson and Ritchie concluded. “Chronic excessive blood loss should be treated as both an urgent and potentially recurrent problem; physicians should address this clinical concern proactively.”

 

REFERENCES

  1. Office on Women’s Health: US Department of Health and Human Services. (2015). Uterine Fibroid Fact Sheet. Retrieved November 10, 2015, from https://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html
  2. The American College of Obstetricians and Gynecologists. (2012). Frequently Asked Questions: Gynecologic Problems. Retrieved November 10, 2015, from http://www.acog.org/-/media/For-Patients/faq095.pdf?dmc=1&ts=20151113T1143331924
  3. Page, L.R. (1997). Renewing Female Balance (4th ed.). Eden Prairie, MN: Healthy Healing Publications.
  4. Puri, K., Famuyide, A. O., Erwin, P. J., Stewart, E. A. Laughlin-Tommaso, S. K. (2014). Submucosal fibroids and the relations to heavy menstrual bleeding and anemia. American Journal of Obstetrics and Gynecology, 210(1): 38.e1-38.e7. doi: 10.1016/j.ajog.2013.09.038
  5. National Heart, Lung, and Blood Institute, US Department of Health & Human Services. (2012). What Are the Signs and Symptoms of Anemia? Retrieved October 14, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/signs
  6. Naito, H., Naka, H., Kanaya, Y., Yamazaki, Y., & Tokinobu, H. (2014). Two cases of acute ischemic stroke associated with iron deficiency anemia due to bleeding from uterine fibroids in middle-aged women. Internal Medicine, 53: 2533-2537. doi: 10.2169/internalmedicine.53.262
  7. Nelson, A. L., & Ritchie, J. J. (2015). Severe anemia from heavy menstrual bleeding requires heightened attention. American Jouranal of Obstetrics and Gynecology, 213(1): 97.e1-97.e6. doi:http://dx.doi.org/10.1016/j.ajog.2015.04.023
  8. Cleveland Clinic. (2011). Hypercoagulable States (Blood Clotting Disorders). Retrieved November 12, 2015, from https://my.clevelandclinic.org/services/heart/disorders/hypercoagstate