While iron deficiency usually gets spoken about in terms of anaemia and exhaustion, its implications for reproductive health need much more discussion. When it comes to planning a pregnancy, iron levels play a critical role, as there is a requirement of sufficient iron. It not only produces haemoglobin but also for oxygenation and metabolism during ovulation and pregnancy.
It is important to understand that iron deficiency is different from iron deficiency anaemia. It is possible for a woman to suffer from iron deficiency even before reaching the level of iron deficiency anaemia. This means that the condition can go unnoticed until the onset of its symptoms like exhaustion or decreased stamina, which can easily be mistaken for work-related issues.
Why Are Women More Vulnerable
Menstruation is among the major factors which make women who are of childbearing age vulnerable to iron deficiency. Menstrual cycles bring about blood loss, and those women who experience excessive menstrual bleeding could be prone to losing considerable amounts of iron.
It is especially important to consider the relationship between menstruation and the intake of iron through diet. In cases where the consumption of food with high levels of iron is low, or a particular diet is used, there is an increased danger of deficiency.
Those women who suffer from conditions such as uterine fibroids or adenomyosis might be more prone to iron deficiency, considering the considerable loss of iron through menstruation.
Could Low Iron Affect Fertility?
The association between iron and fertility is more complicated than claiming that an iron deficiency leads to infertility. Nevertheless, iron is required for several processes in our body, which influence the reproductive function of women. Some studies have linked sufficient iron levels to fertility because of ovulation and have suggested that treatment of iron deficiency is especially important in case of excessive menstrual blood loss and malnutrition.
It is crucial not to consider iron supplementation as a solution to infertility problems. If a woman suffers from infertility, she must undergo diagnostic procedures to determine the cause of her infertility - ovulation, ovarian insufficiency, endometriosis, tube factor, uterus factor or male factor infertility.
Iron Status Becomes Even More Important Before Pregnancy
The reproductive significance of iron comes into light after the woman gets pregnant. This is because there is a marked rise in the requirement of iron in the body when the woman becomes pregnant. There is an increased need for iron because there is an increase in blood volume and because the placenta and the foetus have the need for iron.
Having low reserves of iron before getting pregnant means that it will be hard for the woman to meet the increased needs of iron.
Heavy Periods Should Not Be Normalised
One of the most practical early warning signs is menorrhagia. For women who have extremely heavy menstrual cycles, passing large clots, or require frequent changing of sanitary products, do not ignore it because it is "normal." Other than impacting the quality of life, excessive bleeding will eventually lead to iron deficiency.
However, it is important to find out why there is excessive bleeding. There are conditions such as fibroids, adenomyosis, hormonal imbalances, among others that cause heavy menstrual bleeding.
What Should Women Check?
Complete blood count tests can detect anaemia, as haemoglobin is not always an indication that shows that a person's body iron reserves are low. Tests for ferritin levels in serum are commonly conducted for evaluation of the individual's iron stores; however, ferritin tests are usually influenced by the state of inflammation.
If the female patient complains about signs of fatigue, menorrhagia, a restricted diet, history of iron deficiency or other factors that put her at risk, she should visit her doctor for further tests rather than take iron supplements.
Food First, Supplementation As Required
Sources of iron-rich foods include meat, poultry, and fish and plant products are lentils, beans, chickpeas, green leafy vegetables, and nuts.
The form of the iron will determine how well the iron will be absorbed since haem iron is absorbed better than non-haem iron.
Foods that contain high amounts of vitamin C will enhance the absorption of non-haem iron, while tea and coffee taken during mealtimes will lower iron absorption. Nevertheless, if a patient suffers from substantial iron deficiency, medical supervision of supplementation is required.
The Reproductive Health Connection
Iron deficiency should not be viewed as a stand-alone nutritional issue in women preparing for pregnancy. Sometimes it may be a sign of something else that needs to be addressed, especially heavy menstrual blood loss or a poor nutritional intake.
In preparation for pregnancy, it is not just about ensuring whether the woman's haemoglobin level is 'normal'. The broader perspective that considers the issue of blood loss from menstruation, iron stores, nutrition, and reproductive health in general will help identify any deficiencies early on.
(By Dr Dharna Desai, Fertility Specialist, Nova IVF Fertility, Surat)
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