{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:40:24Z","timestamp":1790196024639,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>For girls and women in their reproductive years, the symptom of heavy menstrual bleeding (HMB) is the most common cause of iron deficiency (ID), including the extreme manifestation of iron deficiency anemia (IDA). It is recognized that these two clinical entities are not only ubiquitous, but their interrelationship is poorly appreciated and frequently normalized by society, healthcare providers, and affected girls and women themselves. Both HMB and ID\/IDA adversely impact quality of life\u2014HMB during the episodes of bleeding and ID daily as long as the ID exists. These combined issues undermine the lives of reproductive\u2010aged girls and women of all ages, from menarche to menopause. At the same time, pervading culture and the often insidious nature of these disorders frequently lead to societal normalization, including by healthcare professionals. The effects on cognitive function as well as the related work and school absenteeism and presenteeism can undermine the efforts and function of women in all walks of life, be they students, educators, employers, or employees. There is also an increasing body of evidence suggesting that ID, even in early pregnancy, may adversely impact fetal neurodevelopment with enduring effects on a spectrum of cognitive and psychological disorders\u2014effects that can have widespread impacts on society. Collectively, this critically important evidence begs the implementation of diagnostic and management guidelines aimed at identifying iron\u2010deficient girls and women, repleting their iron stores, and, when present, effectively treating the most common reason for the problem\u2014the various causes of the symptom of HMB.<\/jats:p>","DOI":"10.1002\/ijgo.14943","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T07:17:19Z","timestamp":1691133439000},"page":"7-13","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Heavy menstrual bleeding, iron deficiency, and iron deficiency anemia: Framing the issue"],"prefix":"10.1002","volume":"162","author":[{"given":"Malcolm G.","family":"Munro","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology David Geffen School of Medicine, University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Institute for Health and Care Excellence.Heavy Menstrual Bleeding: Assessment and management. NICE guideline [NG88]. Published March 2018 updated May 2021. Accessed December 17 2022.https:\/\/www.nice.org.uk\/guidance\/ng88."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.09.027"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.048"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2014.00096"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002103"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2007.00168.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-020-00986-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2021.1925881"},{"key":"e_1_2_8_10_1","volume-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"World Health Organization","year":"2011"},{"key":"e_1_2_8_11_1","volume-title":"Worldwide prevalence of anaemia 1993\u20132005: WHO global database on aenemia","author":"Benoist B","year":"2008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980008002401"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2016.09.007"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2012.3713"},{"key":"e_1_2_8_15_1","volume-title":"The global prevalence of anaemia in 2011","author":"World Health Organization","year":"2015"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2017.02.004"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.103366"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0b013e32834e8291"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32594-0"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/voxs.12377"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25800"},{"key":"e_1_2_8_22_1","unstructured":"National Institutes of Health.Iron. Fact Sheet for Health Professionals. Updated April 2022. Accessed February 12 2023.https:\/\/ods.od.nih.gov\/factsheets\/Iron\u2010HealthProfessional\/#:~:text=Iron%20Intakes%20and%20Status"},{"key":"e_1_2_8_23_1","first-page":"165","article-title":"The effect of iron therapy on the exercise capacity of nonanemic iron\u2010deficient adolescent runners","volume":"142","author":"Rowland TW","year":"1988","journal-title":"Am J Dis Child"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)02341-0"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.6.1381"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15432"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.03.006"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021004352"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2012.636916"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12394"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-06-508325"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.8"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.12.36"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12292"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2007.01586.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199206000-00002"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199303000-00006"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199401000-00004"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/918179"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.35.2.644"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-021-01462-7"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008978114650"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.4.850"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.2.267"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026186"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(02)02094-X"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2008.07.002"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3443"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.120688"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-018-0204-8"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022007066"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(21)00168-X"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13469"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-05-642223"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-019-03871-z"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.129114"},{"key":"e_1_2_8_57_1","unstructured":"Ash Clinical News.Questions and controversies in iron deficiency anemia. October 2020. Accessed December 21 2022.https:\/\/ashpublications.org\/ashclinicalnews\/news\/5312\/Questions\u2010and\u2010Controversies\u2010in\u2010Iron\u2010Deficiency."},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.11.011"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12666"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2007.01496.x"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.225656"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00176.x"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1089\/152460902753473444"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2011.3147"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2012.759096"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00519-0"},{"key":"e_1_2_8_67_1","volume-title":"Iron deficiency anaemia: assessment, prevention and control","author":"World Heath Organization","year":"2001"},{"key":"e_1_2_8_68_1","first-page":"e55","article-title":"Anemia in pregnancy: ACOG practice bulletin, number 233","volume":"2","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics","year":"2021","journal-title":"Obstet Gynecol"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T03:55:25Z","timestamp":1692330925000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.14943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":67,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/ijgo.14943"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.14943","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"2023-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}