Why Do Many Women Suffer From Anemia?

What Is Anemia?

Anemia is characterized by a decrease in red blood cells, hemoglobin, or both, lower than the normal range. Hemoglobin is the protein present in the red blood cells which carries oxygen to different tissues from the lungs and transports carbon dioxide from various tissues to the lungs. A decrease in either of them causes anemia.

There are different types of anemia like iron deficiency anemia, sickle-cell anemia, megaloblastic anemia, etc. Out of all these, iron-deficiency anemia is most commonly seen among women almost of all ages. Iron-deficiency anemia occurs due to a lack of iron in the body, which is needed to synthesize hemoglobin. Pregnant and menstruating women experiencing heavy periods are at high risk.

The symptoms of anemia occur gradually, and it is noticed mainly by the patient or his family when the symptoms become moderate to severe. The signs and symptoms of anemia include the following:

• Headache.

• Generalized weakness.

• Fatigue.

• Paleness of the skin, nails, and palpebral conjunctiva of the eyes.

• Lightheadedness.

• Irregular or fast heartbeat.

• Cold extremities.

• Shortness of breath, especially when doing physical work.

• Brittle nails.

What Causes Anemia in Women?

Anemia in women occurs due to various reasons. They are listed as:

1) Increased Loss of Blood: Heavy bleeding leads to loss of blood, iron, and red blood cells, which become difficult for the body to replace. Heavy bleeding can occur because of the following:

• Digestive issues like ulcers, polyps, and cancer.

• Prolonged use of certain medications such as Aspirin.

• Extended and heavy menstrual bleeding.

• Fibroids in the uterus.

• Donating blood frequently.

2) Increased Demand for Iron During Pregnancy: The entire pregnancy period demands more iron than usual, both for the normal health of the parturient and the offspring.

3) Decreased Iron Intake: The need for iron in the body is fulfilled by the dietary sources containing iron such as meat, chicken, fish, green leafy vegetables, dried beans, fruits, etc.

4) Less or Restricted Iron Absorption: Some medical conditions lead to decreased or restricted iron absorption, like Crohn's disease, celiac disease, etc.

5) Deficiency of Vitamin C: Certain plant-based sources of iron need vitamin C so that the body can absorb its iron. The lack of vitamin C impedes iron absorption.

What Is the Cause of Anemia in Pediatric and Premenstrual Females?

Children are also at high risk of anemia, especially premature or low-birth-weight babies. Feeding babies with cow's milk below the age of one year usually results in iron deficiency, as cow's milk contains less iron, and the babies at this age are dependent on milk only.

The various causes of anemia in pre-adolescent girls are loss of erythrocytes and increased demand for iron due to the ongoing growth. As the body height and muscle mass increase, the need for more iron occurs. Low red blood cell count because of the inability of the body to make sufficient cells or their destruction is also a contributing factor. However, decreased red blood cells or low hemoglobin levels occur because of chronic infections or prolonged medication, as seen in hemolytic anemia, inherited defects like sickle-cell anemia and thalassemia, certain medical conditions, dietary insufficiency of some vitamins and minerals, prolonged illnesses, etc.

Other common symptoms of anemia, swollen tongue, enlarged liver or spleen, jaundice, absent or delayed menstruation, delayed growth and development, and poor wound healing are also seen among anemic children.

What Causes Anemia in Women of Reproductive Age?

Anemia in women aged 15 to 49 years is the most common of all age groups. WHO (World Health Organization) states that one-third of all women of reproductive age are anemic, that is 33 %. Also, 29.9 % of women of 15 to 49 years suffered from anemia in 2019, as per the WHO reports. For teenage girls, the need for iron remains high because of the growth and new development in the body, like puberty. The loss of blood during menstruation is an essential factor contributing to anemia. Almost one-third of the girls develop anemia at puberty due to chronic blood loss (menorrhagia) and abnormal menstrual function. The patients suffering from iron-deficiency anemia lose more blood during menstruation than healthy females.

Bleeding in women after parturition and menorrhagia are two other big reasons for anemia in this age range. Anemia occurs predominantly in women with preterm labor and less in those with term delivery. In women with premature labor, anemia is also caused due to surgical approaches taken for fetal delivery. Uterine diseases like uterine fibroids or uterine polyps causing uterine bleeding also lead to iron-deficiency anemia.

Why Does Anemia Occur in Pregnant Women Who Do Not Take Folate Supplements?

Anemia in pregnant women is usually found because, during this phase, the demand for iron becomes almost double than that required by non-pregnant women. This demand is a physiological call, and the iron needed is used for the normal development of the fetus. Often, the dietary sources of iron cannot meet this demand, and without folate supplements, the deficiency of iron occurs in the pregnant female. Anemia during pregnancy results in the baby's premature birth or a low-birth-weight baby. According to WHO, anemia occurs in 40 % of pregnant women globally.

During pregnancy, the iron and ferritin in the serum and the percentage of transferrin get reduced, leading to a rise in plasma level and total iron-binding capacity. The increased demand for iron is partially fulfilled by the increase in intestinal absorption and the iron reserves in the body, so taking iron supplements during pregnancy becomes necessary for women. The iron deficiency often remains latent until severe symptoms occur, resulting in exhaustion of iron reserves in the initial pregnancy. This deficiency may result in severe complications and abnormalities in the fetus.

What Causes Anemia and Low Iron Levels in Post-Menopausal Women?

In older women who do not experience menstruation, anemia occurs due to deficiency of micronutrients such as iron, folate, and vitamin B12 as a result of less dietary intake; blood loss because of conditions like hiatal hernia, hemorrhoids, constipation, overuse of medications like non-steroidal anti-inflammatory drugs (NSAIDs); genetic influences those of TMPRSS6, HFE (hemochromatosis gene), transferrin, and hepcidin; reduced bioavailability of micronutrients owing to decreased iron absorption seen in diseases such as celiac disease, ulcerative colitis, Crohn's disease.

Another highly considerable reason for anemia in post-menopausal women is that iron supplements are not of many benefits due to the decreased absorption rate of iron.

Conclusion:

If anemia is not treated, it can result in serious health issues like:

• Severe Fatigue: This creates difficulty for the patients to participate in daily activities and complete their daily chores.

• Problems in Conceiving: Iron deficiency makes it hard for an anemic woman to conceive a baby.

• Complications in Pregnancy: Anemic women usually have premature labor and may even deliver low-birth-weight babies.

• Cardiac Issues: Prolonged anemia in women also lead to life-threatening medical conditions like cardiomegaly, cardiac arrest, etc.

• Death: The inherited type of anemia like thalassemia and sickle cell anemia may cause death after sudden blood loss.

Certain types of anemia like thalassemia cannot be prevented, and proper care and precautionary measures should be taken in such cases. Iron deficiency and vitamin deficiency anemias can be prevented by taking a healthy and balanced diet.