The need to screen for anemia in exercising women.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
01 Oct 2021
01 Oct 2021
Historique:
received:
12
07
2021
accepted:
31
08
2021
entrez:
1
10
2021
pubmed:
2
10
2021
medline:
28
10
2021
Statut:
ppublish
Résumé
Anemia is common, affecting 1 in 3 women in their lifetime. Despite high prevalence rates, awareness is poor. This is relevant for women undertaking sport as anemia can lead to reduced physical performance. There is no current screening program for testing of anemia for exercising women. Therefore, the objective of the present study was to assess a simple screening tool to predict anemia in exercising women.Cross sectional survey study.National fitness festival.Three hundred exercising women.Screening methodology (Female Health Questionnaire and a haemoglobin concentration measurement).The Female Health Questionnaire inquired about; previous iron status, menstrual blood loss, diet, and motherhood. Participants were asked to self-report any symptoms of iron deficiency, including; brain fog, palpitations, shortness of breath, restless legs, hair loss, and pica. Results were compared to fingerprick haemoglobin levels with anemia defined as [Hb] < 120 g/L.Average age was 31.21years (s.d.7.72), average [Hb] was 131.76 g/L (s.d.11.5) and 36 (12%) had anemia. A history of iron deficiency was reported by 127 (43.49%), 127 (43.49%) reported heavy menstrual bleeding (HMB), 75 were vegetarian (18%) or vegan (8%) and 33 were mothers (11%). In total 80 reported taking time off work (total 1612 days). Women with anemia more commonly reported HMB (58.33% vs. 41.57%, P = .04), and those with HMB were more likely to report days off (39.37% vs. 18.18%, P < .001).Anemia was common in exercising women, particularly those with HMB. A simple screening tool for HMB and finger prick haemoglobin testing for anemia is recommended in women undertaking exercise.
Identifiants
pubmed: 34596123
doi: 10.1097/MD.0000000000027271
pii: 00005792-202110010-00017
pmc: PMC8483825
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e27271Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interests to disclose.
Références
Stevens GA, Finucane MM, De-Regil LM, Klein L AA. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Global Health 2013;1:e16–25.
Butcher A, Richards T, Stanworh SJ, Klein AA. Diagnostic criteria for pre-operative anaemia-time to end sex discrimination. Anaesthesia 2017;72:811–4.
Coulter A, Peto V, Jenkinson C. Quality of life and patient satisfaction following treatment for menorrhagia. Fam Pract 1994;11:394–401.
Napolitano M, Dolce A, Celenza G, et al. Iron-dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses. Ann Hematol 2014;93:557–63.
McCormick A, Fleming D, Charlton J. Morbidity Statistics from General Practice. Fourth national study 1991–1992. OPCS Series MB5 no. 3. London: HMSO; 1995.
Rubeor A, Goojha C, Manning J, et al. Does iron supplementation improve performance in iron-deficient nonanemic athletes? Sports Health 2018;10:400–5.
Rowland T. Iron deficiency in athletes: an update. Am J Lifestyle Med 2012;6:319–27.
Pasricha S-R, Tye-Din J, Muckenthaler MU, et al. Iron deficiency. Lancet 2020.
Longo DL, Camaschella C. Iron-deficiency anemia. N Eng J Med 2015;372:1832–43.
Peuranpää P, Heliövaara-Peippo S, Fraser I, et al. Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding. Acta Obstetricia et Gynecologica Scandinavica 2014;93:654–60.
Schmidt W, Prommer N. Impact of alterations in total hemoglobin mass on V̇ O2max. Exercise Sport Sci Rev 2010;38:68–75.
Karlsson TS, Marions LB, Edlund MG. Heavy menstrual bleeding significantly affects quality of life. Acta Obstetricia et Gynecologica Scandinavica 2014;93:52–7.
Fraser IS, Mansour D, Breymann C, et al. Prevalence of heavy menstrual bleeding and experiences of affected women in a European patient survey. Int J Gynecol Obstet 2015;128:196–200.
Hallberg L, Högdahl AM, Nilsson L, et al. Menstrual blood loss and iron deficiency. Acta Medica Scandinavica 1966;180:639–50.
National Collaborating Centre for Women's and Children's Health (UK). Heavy Menstrual Bleeding. London: RCOG Press; 2007 Jan.
Bushnell DM, Martin ML, Moore KA, et al. Menorrhagia impact questionnaire: assessing the influence of heavy menstrual bleeding on quality of life. Curr Med Res Opinion 2010;26:2745–55.
Shankar M, Chi C, Kadir RA. Review of quality of life: menorrhagia in women with or without inherited bleeding disorders. Haemophilia 2008;14:15–20.
Liu Z, Doan QV, Blumenthal P, et al. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value in Health 2007;10:183–94.
Warner P, Critchley HO, Lumsden MA, et al. Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management. BMJ 2001;323:24–8.
Fraser IS, Langham S, Uhl-Hochgraeber K. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Obstetrics Gynecol 2009;4:179–89.
Matteson KA, Boardman LA, Munro MG, et al. Abnormal uterine bleeding: a review of patient-based outcome measures. Fertility Sterility 2009;92:205–16.
Lukes AS, Baker J, Eder S, et al. Daily menstrual blood loss and quality of life in women with heavy menstrual bleeding. Women's Health 2012;8:503–11.
Bruinvels G, Burden RJ, McGregor AJ, et al. Sport, exercise and the menstrual cycle: where is the research? Br J Sports Med 2017;51:487–8.
Bruinvels G, Burden R, Brown N, Richards T, Pedlar C. The prevalence and impact of heavy menstrual bleeding (menorrhagia) in elite and non-elite athletes. PLoS One 2016;11:e0149881.
Bruinvels G, Burden R, Brown N, et al. The prevalence and impact of heavy menstrual bleeding among athletes and mass start runners of the 2015 London Marathon. Br J Sports Med 2016;50:566–1566.
Bruinvels G, Pedlar C, Burden R, Yong TT, Cushway T, Richards T. Heavy menstrual bleeding and iron status in exercising women in Singapore. 17th Annual NATA Symposium; April 2016.
Dugan C, Maclean B, Cabolis K, et al. The misogyny of iron deficiency. Anesthesia 2021;76(S4):56–62.
World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity (No. WHO/NMH/NHD/MNM/11.1). World Health Organization; 2011.
Kassebaum NJ. The global burden of anemia. Hematol/Oncol Clin 2016;30:247–308.
Harvey LJ, Armah CN, Dainty JR, et al. Impact of menstrual blood loss and diet on iron deficiency among women in the UK. Br J Nut 2005;94:557–64.
Schoep ME, Adang EMM, Maas JWM, De Bie B, Aarts JWM, Nieboer TE. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open 2019;9:e026186.
Schoep ME, Nieboer TE, Van Der Zanden M, et al. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstetrics Gynecol 2019;220:569e1–7.
Bitzer J, Heikinheimo O, Nelson AL, et al. Medical management of heavy menstrual bleeding: a comprehensive review of the literature. Obstet Gynecological Survey 2015;70:115–30.
El-Hemaidi I, Gharaibeh A, Shehata H. Menorrhagia and bleeding disorders. Curr Opinion Obstet Gynecol 2007;19:513–20.
Morrison J, Patel ST, Watson W, et al. Assessment of the prevalence and impact of anemia on women hospitalized for gynecologic conditions associated with heavy uterine bleeding. J Reproduct Med 2008;53:323–30.
Bruinvels G, Burden RJ, Cushway T, et al. The impact of heavy menstrual bleeding (menorrhagia) and iron status in exercising females. Br J Sports Med 2017;51:304–1304.
2009;Frick KD, Clark MA, Steinwachs DM, et al. Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment. 19:70–8.
Spencer JC, Louie M, Moulder JK, et al. Cost-effectiveness of treatments for heavy menstrual bleeding. Am J Obstet Gynecol 2017;217:574e1–9.
Pasricha S-R, Low M, Thompson J, et al. Iron supplementation benefits physical performance in women of reproductive age: a systematic review and meta-analysis. J Nut 2014;144:906–14.
Burden RJ, Morton K, Richards T, et al. Is iron treatment beneficial in, iron-deficient but non-anaemic (IDNA) endurance athletes? A systematic review and meta-analysis. Br J Sports Med 2015;49:1389–97.
Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose. Drugs 2009;69:739–56.
Favrat B, Balck K, Breymann C, et al. Evaluation of a single dose of ferric carboxymaltose in fatigued, iron-deficient women–PREFER a randomized, placebo-controlled study. PloS One 2014;9:e94217.
Woods A, Garvican-Lewis LA, Saunders PU, et al. Four weeks of IV iron supplementation reduces perceived fatigue and mood disturbance in distance runners. PloS One 2014;9:e108042.
Burden RJ, Pollock N, Whyte GP, et al. Effect of intravenous iron on aerobic capacity and iron metabolism in elite athletes. Med Sci Sports Exercise 2015;47:1399–407.
Ponikowski P, Filippatos G, Colet JC, et al. The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study. Eur J Heart Failure 2015;17:329–39.
Houston BL, Hurrie D, Graham J, et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open 2018;8:e019240.
Miles LF, Litton E, Imberger G, Story D. Intravenous iron therapy for non-anaemic, iron-deficient adults. Cochrane Database Syst Rev 2019;12:CD013084.