Iron deficiency in peri-menopausal women: Clinical considerations from an expert consensus

Abstract

Background: Iron deficiency (ID) and iron deficiency anaemia (IDA) are usually anticipated to occur during and after pregnancy. Peri-menopausal women are at risk of ID/IDA & warrant attention as the symptoms of ID can be misinterpreted or overlooked. Scientific literatures convey iron deficiency to be considered as a major health problem for perimenopausal women. However, Indian evidence on ‘Iron deficiency in peri-menopausal women’ is scarce. Aim: The aim of this article is to understand the impact of iron deficiency on health of peri-menopausal women in India and to understand its important clinical considerations. Developing an expert consensus towards diagnosis & management of iron deficiency and iron deficiency anaemia in this population is the need of the hour. Materials and Methods: A 3-step modified Delphi method was used to build up the consensus. Nine experts representing gynaecology and endocrinology were invited to participate in the panel discussion. Session was being moderated by a senior gynaecologist. In round 1 – the prevalence of iron deficiency anemia in perimenopausal women and risk factors of iron deficiency anemia were discussed. The panel members asked polling questions and each member’s response to the poll question was recorded. The same voting method was used in round 2 and 3, which discussed the diagnosis and management, respectively. Results: In round 1, round 2 and round 3 statements reached consensus. Consensus was attained for eleven statements representing four different domains: prevalence, risk factors, diagnosis, and treatment. Conclusion: This consensus guideline will help to standardize care, provide guidance on screening and treatment of iron deficiency anemia in perimenopausal women. This will also assist in clinical decision-making for all healthcare professionals.