Specifics of the clinical course of iron deficiency anemia among women aged 40-55 years

  • S. A. Guseva Ukrainian Military Medical Academy
  • Ya. B. Savchenko National Military Medical Clinical Center "Main Military Clinical Hospital"
Keywords: women aged 40-55 years, iron deficiency, iron deficiency anemia, causes of development, therapy


Introduction. Iron deficiency (ID) is a serious problem in women aged 40-55 years. During this period there are variations in hormonal levels, menstrual irregularities with the risk of severe blood loss. In addition, women in this age group often lead unhealthy lifestyles, followed by the development of disorders that lead to changes in physical and mental states.

The purpose: to determine the causes of iron deficiency anemia in women who were under observation in the hematology clinic of the National Military Medical Clinical Center «Main Military Clinical Hospital» of the Ministry of Defense of Ukraine and identify risk factors for anemia and its correction.

Materials and methods. The article presents data from European studies on the high risk of developing iron deficiency / iron deficiency anemia (IDA) in women aged 40-55 years. The analysis of examination and treatment of 109 women who were under observation in the hematology clinic of the National Military Medical Clinical Center «GVKG» (Kyiv) from 2015 to 2019.

Results. Modern European scientific research on the risk of developing ІD / IDA in women aged 40-55 years is summarized. An analysis of the causes of IDA in women based on the results of examination and treatment of women who were under observation in the hematology clinic of the National Military Medical Clinical Center «GVKG» (Kyiv) from 2015 to 2019. The most common causes of ID / IDA are: heavy menstrual blood loss, inflammatory processes in the gastrointestinal tract, reduced consumption of meat products, anticoagulants, dietary disorders for weight loss, which is generally 75% of the possible causes.

Conclusions. According to European studies, there is a high risk of developing ID / IDA in women aged 40-55 years, while the clinical manifestations of IDA in women aged 40-55 years is a public health problem, as it leads not only to reduced efficiency but also to reduced quality of women life. The results of the studies indicate a multifactorial structure of the causes of IDA in women aged 40-55 years, the main of which are abundant menstrual blood loss (21.1%), inflammatory processes in the gastrointestinal tract (19.26%), reduced use of meat products (13.76%), anticoagulants (10.1%). It is shown that determining the risk factors for the development of anemia and the correction of these negative manifestations with the help of iron supplements is an urgent task for the doctor.


Kassebaum N.J., Jasrasaria R, Naghavi M. et al. (2014). A systematic analysis of global anemia burden from 1990 to 2010. Blood, 123, 615–624.

Nicula R., Costin N. 2015 (). Management of endometrial modifications in perimenopausal women. Clujul Medical journal, 88, 101–110.

Beard J., Tobin B. (2000). Iron status and exercise. The American Journal of Clinical Nutrition, 72, 594–597.

Peuranpa. P., Helio.vaara-Peippo S., Fraser I., et al. (2014). Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding. Acta Obstet Gynecol Scand, 93, 654–660.

Verdon F., Burnand B., Stubi C.L., et al. (2003). Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomized placebo controlled trial. British Medical Journal, 326, 1124.

Firquet A., Kirschner W., Bitzer J. (2017). Forty to fifty-five-year-old women and iron deficiency: clinical considerations and quality of life. Gynecological Endocrinology, 33, 7, 503-509.

World Health Organization [Internet]. Geneva: World Health Organization; 2011 [cited 2017 Feb 02]. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Available from: www.who.int/vmnis/indicators/haemoglobin.pdf.

Koo B.B., Bagai K., Walters A.S. (2016). Restless legs syndrome: current concepts about disease pathophysiology. Tremor. Other Hyperkinetic. Mov. (NY), 22, 401.

Levi M., Rosselli M., Simonetti M., et al. (2016). Epidemiology of iron deficiency anaemia in four European countries: a population-based study in primary care. European Journal of Haematology, 97, 583–593.

British Columbia Guidelines—Iron deficiency. Vancouver; 2010 [cited 2017 Feb 02]. Available from: http://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/iron-deficiency.

Low M.S., Speedy J., Styles C.E., et al. (2016). Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst. Rev, 4, CD009747

Murray-Kolb L.E. (2011). Iron status and neuropsychological consequences in women of reproductive age: what do we know and where are we headed? The American Journal of Clinical Nutrition, 141, 747–755.

Stein J., Connor S., Virgin G., et al. (2016). Anemia and iron deficiency in gastrointestinal and liver conditions. World Journal of Gastroenterology, 22, 7908–7925.

Saunders A.V., Craig W.J., Baines S.K., et al. (2013). Iron and vegetarian diets. The Medical Journal of Australia, 199, 11–16.

Wojciak R.W. (2014). Effect of short-term food restriction on iron metabolism, relative well-being and depression symptoms in healthy women. Eating and Weight Disorders, 19, 321–327.

Dorsey K.A. (2013). Menorrhagia, active component service women, U.S. Armed Forces 1998–2012. MSMR, 20, 20–24.

Waldmann A., Koschizke J.W., Leitzmann C., et al. (2004). Dietary iron intake and iron status of German female vegans: results of the German vegan study. Annals of Nutrition and Metabolism, 48, 103–108.

Marret H., Fauconnier A., Chabbert-Buffet N., et al. (2010). Clinical practice guidelines on menorrhagia: management of abnormal uterine bleeding before menopause. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 152, 133–137.

Santer M, Wyke S, Warner P. (2007). What aspects of periods are most bothersome for women reporting heavy menstrual bleeding? Community survey and qualitative study. BMC Womens Health, 7, 8.

Matteson K.A., Scott D.M., Raker C.A., et al. (2015). The menstrual bleeding questionnaire: development and validation of a comprehensive patient-reported outcome instrument for heavy menstrual bleeding. An International Journal of Obstetrics & Gynaecology, 122, 681–689.

Munro M.G., Critchley H.O., Broder M.S., et al. (2011). FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. International Journal of Gynecology & Obstetrics, 113, 3–13.

NICE [Internet]. London: NICE; 2016 Update [cited 2017 Feb 02]. Heavy menstrual bleeding: assessment and management clinical guideline. Available from: https://www.nice.org.uk/guidance/CG44/chapter/Recommendations#pharmaceutical-treatments-for-hmb.

Galan P., Yoon H.C., Preziosi P., et al. (1998). Determining factors in the iron status of adult women in the SU.VI.MAX study. Supplementation en Vіtamines et Mine.raux AntioXydants. European Journal of Clinical Nutrition, 52, 383–388.

Green B.T., Rockey D.C. (2004) Gastrointestinal endoscopic evaluation of premenopausal women with iron deficiency anemia. Journal of Clinical Gastroenterology, 38, 104–109.

Hudak L., Jaraisy A., Haj S., et al. (2017). An updated systematic review and meta-analysis on the association between Helicobacter pylori infection and iron deficiency anemia. Helicobacter, 22, e12330. doi: 10.1111/hel.12330.

World Health Organization. Guideline: daily iron supplementation in adult women and adolescent girls. Geneva: World Health Organization. 2016.

Fashner J., Gitu A.C. (2013). Common gastrointestinal symptoms: risks of long-term proton pump inhibitor therapy. FP Essent, 413, 29–39.

Coad J., Pedley K. (2014). Iron deficiency and iron deficiency anemia in women. Scandinavian Journal of Clinical and Laboratory Investigation, 244, 82–89.

Stein J., Connor S., Virgin G., et al. (2016). Anemia and iron deficiency in gastrointestinal and liver conditions. World Journal of Gastroenterology, 22, 7908–7925.

Goddard A.F., James M.W., McIntyre A.S., et al. (2011). Guidelines for the management of iron deficiency anemia. Gut, 60, 1309–1316.

Qamar K., Saboor M., Qudsia F., et al. (2015). Malabsorption of iron as a cause of iron deficiency anemia in postmenopausal women. Journal of Pakistan Medical Association, 31, 304–308.

Aigner E, Feldman A, Datz C. (2014). Obesity as an emerging risk factor for iron deficiency. Nutrients, 6, 3587–3600.

Alaunyte I., Stojceska V., Plunkett A. (2015). Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance. The Journal of the International Society of Sports Nutrition, 12, 38, doi: 10.1186/s12970-015-0099-2

Cade J.E., Moreton J.A., O’Hara B., et al. (2005). Diet and genetic factors associated with iron status in middle-aged women. The American Journal of Clinical Nutrition, 82, 813–820.

Palacios S. (2012). Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview. The Scientific World Journal, 2012. ID 846824.

Leary A., Barthe L., Clavel T., et al. (2016). Pharmacokinetics of ferrous sulphate (Tardyferon_) after single oral dose administration in women with iron deficiency anaemia. Drug research (Stuttgart), 66, 51–56.

Donnez J., Tatarchuk T.F., Bouchard P., et al. (2012). Ulipristal acetate versus placebo for fibroid treatment before surgery. The New England Journal of Medicine, 366, 409–420.

Nisolle M., Closon F., Firquet A., et al. (2014). Ulipristal acetate (Esmya): a selective modulator of progesterone receptors, new treatment of uterine fibromatosis. Revue Medicale de Liege, 69, 220–225.

Zaim M., Piselli L., Fioravanti P., et al. (2012). Efficacy and tolerability of a prolonged release ferrous sulphate formulation in iron deficiency anaemia: a non-inferiority controlled trial. European Journal of Nutrition, 51, 221–229.

Fadeenko G.D., Kushnir I.E. (2009). Treatment of iron deficiency anemia: clinical efficacy and safety of tardyferon. Results of a Multicenter Study Conducted in Ukraine. Suchasna Gastroenterologia, 5, 74–80.

How to Cite
Guseva, S. A., & Savchenko, Y. B. (2021). Specifics of the clinical course of iron deficiency anemia among women aged 40-55 years. Ukrainian Journal of Military Medicine, 2(2), 49-60. https://doi.org/10.46847/ujmm.2021.2(2)-049
Current aspects of diagnosis and treatment