Heavy menstrual bleeding, a condition affecting at least one in three women, is contributing to a widespread and often overlooked health crisis characterized by debilitating fatigue, anemia, and significant impacts on quality of life, according to medical experts.
Emma Cleary, 42, experienced symptoms like light-headedness and extreme tiredness from her early teens, even being nicknamed 'Casper' by classmates due to her pale appearance. Despite numerous doctor visits, her heavy periods were not adequately addressed, and she was diagnosed with anemia at 16 without a clear explanation of its link to her menstrual cycle. It was only in her late 20s that the severity of her condition became undeniable when she began experiencing significant hair loss, impacting her career as a model.
Cleary's experience highlights a broader issue where heavy menstrual bleeding, known as menorrhagia, is often not recognized as a serious health concern. This can lead to prolonged blood loss, resulting in iron deficiency, a condition that can cause dizziness, shortness of breath, and cognitive difficulties often mistaken for other disorders like ADHD or depression.
Research indicates that approximately 36 percent of women of child-bearing age may be iron-deficient, yet only about a quarter receive a formal diagnosis. Iron is crucial for energy levels, cognitive function, and immunity, and losses due to heavy periods can easily exceed dietary intake.
Experts like Dr. Bassel Wattar, associate professor of reproductive medicine at Anglia Ruskin University, describe the situation as a "silent crisis." An analysis published in The Lancet revealed that thousands of women are hospitalized each year due to heavy menstrual bleeding. Wattar noted that current National Health Service (NHS) guidelines and services lack a clear pathway for managing acute heavy menstrual bleeding efficiently, often resulting in temporary fixes and long waiting lists.
"We see thousands of women admitted to hospital for a condition that could often be managed earlier and more effectively in the community," Wattar stated. "This mismanagement leads to women being discharged with temporary fixes, often still anaemic, and left to navigate long waiting lists. We need to shift from reactive to proactive care."
Cleary eventually found relief through a private prescription for tranexamic acid, which reduces menstrual bleeding, and annual iron infusions. "Without it, there’s no way I would have been able to start my own business or be a mum to my two boys," she said, emphasizing that the effective treatments are often not readily available through standard NHS pathways.
Professor Toby Richards, a hematologist at University College London, is advocating for national screening for iron deficiency through a new charity, Shine. A pilot study at the University of East London screened over 900 women, finding that one in three reported heavy periods and 20 percent had anemia. This study also indicated a correlation between iron deficiency and increased reporting of depression symptoms.
"The Shine pilot has shown how targeted screening can prevent ill health and tackle inequalities," said Professor Amanda Broderick, vice-chancellor and president of the University of East London. "It’s already made a real difference for our students – raising awareness of heavy menstrual bleeding and its link to anaemia, and empowering women to take control of their health."