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Healthy Eating: Heavy Menstrual Bleeding And Constant Tiredness

Most girls, over 95%, start their menstrual periods between the ages of 10 and 16 years, with more than a quarter of them reporting heavy bleeding. But what constitutes heavy bleeding?

Usually, quantification of a woman’s menstrual blood loss is based on her subjective assessment, clinically, the measurement of her full blood count is used. This measurement, particularly of red blood cell levels, gives a clearer idea of the nature of a woman’s blood loss. If a woman does indeed have heavy periods she would have diminished levels of red blood cells, which can usually be made worse by poor diet. This usually manifests as iron deficiency anaemia.

The iron deficiency anaemia is the cause of the tiredness and lethargy in women who have heavy menstrual bleeding. This is because the red blood cells play a crucial role in transporting oxygen around the body to wherever it is needed for creating energy for the body. Without the red blood cells there is no oxygen and without the oxygen there is no energy, which explains the tiredness.

Now we know what causes the tiredness, but what next?

After the clinical investigations are complete and iron deficiency anaemia is cited as the cause of tiredness, the doctor has a few options, all aimed at correcting the iron deficiency and maintaining the iron levels at an optimum level. Once this is corrected the body and soul will be rejuvenated and the tiredness will go.

What are the options?

One option is to eat healthy meals as much as possible and to increase dietary iron. Dark green leafy vegetables, liver, meat beans and nuts are all good sources of dietary iron. Vitamin C rich foods will be ideal, as well, because vitamin C helps the body absorb the iron better. Examples of vitamin C rich foods are citrus fruits, kiwi fruits, and broccoli. If this is not enough iron supplements, usually in tablet form, are used to replace the lost iron and to reverse the iron deficiency anaemia. Supplements containing vitamin C are also available. It may take up to 6 months of iron supplementation before the blood iron levels are replenished. Oral iron may cause nausea, but taking it with or after food prevents this.


Another option, ideally, is to stop the heavy blood loss. That is, treating the primary cause – the heavy blood loss – rather than the iron deficiency anaemia, the symptom or secondary cause. This may be achieved by the use of female hormones and other drugs. Surgical procedures, most notably hysterectomy, if acceptable may be beneficial . For women of child-bearing age the use of oral contraceptive pills or an intrauterine device (IUD) can stop or decrease the menstrual blood loss, as well as offering contraceptive cover. For the first 2 to 3 months of using IUD there may be some irregular bleeding or spotting, but after the initial 3 months this stops. Some Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are effective for reducing the blood flow.
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Once the blood loss is reduced, or enough dietary iron is eaten, the body (blood) should be have enough iron for healthy red blood cells and oxygen transport, and ultimately for energy production. This, in turn, will stop the tiredness, boost your vitality and rejuvenate your body. So, if you think your tiredness is be due to heavy menstrual blood loss speak to your doctor and get it sorted!