Uterine Fibroids and Iron Deficiency Anemia

Mechanism of Anemia in Fibroid Patients

Uterine fibroids cause iron deficiency anemia primarily through menorrhagia (heavy menstrual bleeding), which is the most frequent symptom of fibroids and often results in significant blood loss exceeding 80 mL/month, according to the American College of Radiology 1, 2
Heavy menstrual blood loss (≥80 mL/month) is a significant risk factor for iron deficiency anemia, affecting approximately 10% of women in the United States, as reported by the Centers for Disease Control and Prevention 3, 4

Black women have a higher prevalence of fibroids (>80% by age 50) and are more likely to develop clinically significant disease at an earlier age, according to the American College of Radiology 1, 2
Inadequate dietary iron intake is a risk factor, as only one-fourth of women of childbearing age meet the recommended dietary allowance for iron through diet, as reported by the Centers for Disease Control and Prevention 3, 4
Previous diagnosis of iron deficiency anemia increases the risk for recurrent anemia, as stated by the Centers for Disease Control and Prevention 3

Evaluate for iron deficiency anemia in any woman with uterine fibroids who reports heavy or prolonged menstrual bleeding, as recommended by the American College of Radiology 1, 2
Imaging studies (transvaginal ultrasound, saline infusion sonohysterography, or MRI) can determine fibroid location, size, and relationship to the endometrial cavity, according to the American College of Radiology 1

The American College of Obstetricians and Gynecologists recommends hormonal therapies, such as levonorgestrel intrauterine system (IUD), combined oral contraceptives, GnRH agonists or antagonists, and selective progesterone receptor modulators (SPRMs) like ulipristal acetate, to control bleeding and shrink fibroids 5, 6, 7
Abdominal myomectomy for multiple or larger fibroids is a recommended surgical intervention, as stated by the American Journal of Obstetrics and Gynecology 7

The American College of Obstetricians and Gynecologists recommends the use of hormonal contraceptives to reduce menstrual blood loss in women with fibroids, as reported by Praxis Medical Insights 5