Menses and the Appearance of Iron Deficiency

¶ … normal hemoglobin and below normal hematocrit percentages. Her erythrocyte count is also below the normal levels. For ten to twelve years (or for the majority of her life as a menstruating woman) she has suffered from menorrhagia and dysmenorrheal. Because of the heavy bleeding and cramps experienced during menses, as well as the levels of hemoglobin and hematocrit and microcytic/hypochromic cells in her RBC, it is likely that Ms. A has iron-deficiency anemia. This paper will discuss the circumstances and preliminary workup regarding Ms. A's anemic condition explain why this diagnosis is the most likely.

Ms. A is an active, young, 26-year-old woman, who was treated for light headedness, loss of energy, low blood pressure, and elevated heart rate after feeling dizzy at her golf outing. She noted that during her menses (which it is assumed she was experiencing at the time), she typically suffered from heavy bleeding and cramps, taking only aspirin to relieve the pain. There was no indication given that Ms. A was aware of any iron deficiency in her blood or diet.

Anemia is a condition that occurs when one has insufficient hemoglobin (a binder of oxygen) in the red blood cells. What happens is that the blood produces too little oxygen for the body. During menses, women can lose healthy red blood cells and experience fatigue, headaches, light headedness, which is what Ms. an experiences during her golf outing. Because Ms. an experiences excessive bleeding during menses, the loss of RBC and hemoglobin through this provides a rationale/logical explanation for the anemic symptoms. The most common form of anemia in women is iron-deficiency anemia, which can be treated through the use of iron supplements (McDonald, McDonald, 1998).

The appearance of hypochromic cells in the RBC smear indicates that an iron deficiency is likely the cause of Ms. A's anemia. However, a proper diagnosis should be made by investigating Ms. A's history and analyzing her serum iron levels (Brady, 2007). The patient's iron saturation should be tested to see if it is below 5%. If it is higher, iron deficiency diagnosis becomes less clear. If it is above 12%, it is most likely not the proper diagnosis and some other type of anemia may be the cause of Ms. A's symptoms. No diagnosis should be made until these levels are tested so as to avoid improper treatment (Brady, 2007).

If analysis of Ms. A's serum reveals that iron deficiency is indeed the case, iron supplements can remedy the situation and it should be advised to Ms. A that she should partake of iron rich foods especially during her menses if she prefers not to take supplements. A dietary change could have beneficial effects on Ms. A and help to ease her anemic symptoms.