Interactions between menstrual blood loss and iron status

In an SNF SPIRIT project in collaboration with the Training and Research Unit of Excellence in Malawi we investigate the effect of multiple micronutrient supplements as well as ibuprofen on menstrual blood loss in adolescents. Reducing menstrual blood loss in adolescent girls living in low- and middle-income countries (LMIC) may be key to meet their iron requirements for first pregnancy and to prevent severe anemia during pregnancy or after childbirth. Furthermore, an improvement of psychosocial health, education, equity, and empowerment may be achieved. So far, few studies have been undertaken to assess the epidemiology of heavy menstrual bleeding in LMIC. While heavy menstrual blood loss is associated with iron deficiency anemia, self-perceived heavy bleeding is also an important determinant of a women’s physical, emotional, and social quality of life. In smaller sub-studies the project investigates changes in iron metabolism over the menstrual cycle and validates a new method to determine menstrual blood loss using stable iron isotopes. In the main study in Malawi the effect of multiple micronutrient supplementation as well as non-steroidal anti-inflammatory drugs on menstrual blood loss are investigated in a randomized, controlled trial.