{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:25:23Z","timestamp":1783639523898,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary objective was to evaluate the prevalence of undiagnosed iron deficiency in patients with endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multi\u2010center, cross\u2010sectional study at two tertiary care hospitals. We included 251 non\u2010pregnant women (18\u201350\u2009years old) presenting with a clinical or surgical diagnosis of symptomatic endometriosis. Patients who consented to the study underwent screening bloodwork (including complete blood count, ferritin, and transferrin saturation) and completed the study survey assessing demographics, medical and surgical history, and validated questionnaires to assess iron deficiency and endometriosis symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of iron deficiency in our endometriosis cohort was 53.4% (134\/251), and the prevalence of iron deficiency anemia was 13.5% (34\/251). Patients with iron deficiency were more likely to have heavy menstrual bleeding (HMB) compared with patients without iron deficiency (66\/133, 49.6% vs. 40\/115, 34.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). Nonetheless, 58% (142\/251) of our study population did not endorse HMB. Despite absence of HMB, 47% (67\/142) of these patients were iron\u2010deficient. Transferrin saturation was diagnostic for iron deficiency in 63 of 176 patients (35.7%) who had a normal ferritin (\u226530\u2009ng\/mL). Patients with iron deficiency had a significantly lower adjusted median Functional Assessment of Chronic Illness Therapy Fatigue Subscale score compared with those without iron deficiency (26.3. vs. 29.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the high prevalence of iron deficiency, which remains undiagnosed in over half of patients with endometriosis presenting to a gynecologist. Future research should focus on assessing the effectiveness of iron therapy in improving symptoms and overall well\u2010being in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.15994","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T06:20:12Z","timestamp":1732083612000},"page":"1321-1327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["High prevalence of undiagnosed iron deficiency in endometriosis patients: A cross\u2010sectional study"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7198-0868","authenticated-orcid":false,"given":"Hanna R.","family":"Goldberg","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"McCaffrey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Solnik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nucelio","family":"Lemos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Sobel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Kives","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Kinga","family":"Malinowski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Shehata","sequence":"additional","affiliation":[{"name":"Department of Medicine Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Matelski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Szczech","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4216-4172","authenticated-orcid":false,"given":"Ally","family":"Murji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynecology Institute for Better Health, Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"International Federation of Gynecology and Obstetrics.Iron deficiency and anaemia in women and girls.2023Available from: Iron deficiency and anaemia in women and girls | Figo."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14952"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16221"},{"issue":"12","key":"e_1_2_10_6_1","first-page":"1191","article-title":"Iron deficiency, depression, and fatigue in inflammatory bowel diseases","volume":"58","author":"K\u00f6nig P","year":"2020","journal-title":"Gastroenterology"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.09.027"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14948"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14943"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v6.i3.339"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223316"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmw031"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa033"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey115"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2020.06.022"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.10.2715"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:QURE.0000021321.48041.0e"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-015-0257-x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(96)00274-6"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S169653"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.acc.2016.03.002"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/44.1.45"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23031518"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17900"},{"issue":"5","key":"e_1_2_10_25_1","first-page":"1","article-title":"Mediation: R package for causal mediation analysis","volume":"49","author":"Tingley D","year":"2014","journal-title":"J Stat Softw"},{"key":"e_1_2_10_26_1","volume-title":"R: A Language and Environment for Statistical Computing","year":"2022"},{"key":"e_1_2_10_27_1","volume-title":"Statistics Canada, Catalogue no 82\u2010003\u2010XPE, Health Reports","author":"Cooper M","year":"2012"},{"key":"e_1_2_10_28_1","unstructured":"ManolovV MarinovB VasilevV.Endometriosis and Serum Hepcidin Levels.2013;54:32\u201038."},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.30802\/AALAS-CM-17-000082"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz014"}],"container-title":["International Journal of Gynecology &amp; 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