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A staggering one in three women experience debilitating heavy menstrual bleeding, yet many remain undiagnosed and suffer in silence, leading to severe health consequences like chronic fatigue, hair loss, and even hospitalizations. This “silent public health crisis,” as experts are calling it, is leaving countless women misdiagnosed or dismissed by healthcare providers.
A Decade of Dismissal
For Emma Cleary, now 42 and a mother of two, the struggle began in her early teens. She endured persistent light-headedness and extreme tiredness, earning her the cruel nickname ‘Casper’ from classmates due to her pale appearance. “I kept going back to the doctors but eventually I gave up and just started fending for myself,” she recounts. “It felt like they just wanted me to put up and shut up.” At 16, she received a diagnosis of anaemia, a blood condition caused by iron deficiency, but crucially, no one connected it to her heavy periods.
This disconnect is a common thread in the experiences of many women. Research indicates that a significant number are unaware they are experiencing heavy menstrual bleeding – also known as menorrhagia – and the profound impact it can have on their overall health. Cleary vividly remembers the embarrassment and practical difficulties. “I could easily bleed through dresses and down to my socks, so I became really conscious of what I was wearing,” she says. “I wore black a lot to try to hide it. But growing up, I just thought that was normal. It wasn’t something I spoke about with friends or even my mum. I assumed this was what everyone was going through, so I just got on with it.”
The Impact on Daily Life
Despite repeated visits to her general practitioner, Cleary’s heavy periods were never adequately addressed. Iron supplements offered minimal relief. By her late 20s, working as a model, the consequences became impossible to ignore: significant hair loss. “All women are conscious of their looks, but this was my livelihood,” she explains. “I would go to shoots and the make-up artists would have to colour in my scalp to make the hair loss less visible.”
The impact extended beyond her career. Cleary recalls a particularly frightening incident at the supermarket at age 35. “I was queuing…and felt terrible – dizzy, exhausted and bleeding heavily – but I was just trying to get through,” she remembers. She fainted, collapsing into a flower display. “When I came round, all I could see were flowers, and I genuinely thought I’d died and it was my funeral. Then it hit me how embarrassing it was – being 35 years old and having your dad come and pick you up from the shop.”
A Systemic Failure
Cleary’s story is not unique. Experts argue that failures in recognizing and addressing heavy menstrual bleeding constitute a systemic issue. Last month, an analysis published in The Lancet by researchers at Anglia Ruskin University revealed that thousands of women are admitted to hospital annually due to complications stemming from heavy periods.
“This is a silent crisis in women’s health,” states Dr. Bassel Wattar, associate professor of reproductive medicine at the university. “We see thousands of women admitted to hospital for a condition that could often be managed earlier and more effectively in the community. Guidelines and services in the NHS do not provide a clear pathway for managing acute heavy menstrual bleeding efficiently.” He emphasizes that this mismanagement often results in women being discharged with temporary solutions, still anaemic, and facing lengthy waiting lists for further care. “We need to shift from reactive to proactive care.”
Understanding Heavy Menstrual Bleeding and Iron Deficiency
Periods are considered heavy when blood loss interferes with daily life. This can manifest as regularly soaking through pads, tampons, or clothing; needing to change sanitary products every 30 to 120 minutes; or having to adjust work and social plans due to blood loss. Menorrhagia can be treated with hormonal contraceptives or tranexamic acid, a medication that reduces menstrual bleeding.
However, prolonged heavy bleeding frequently leads to iron deficiency. Studies suggest that 36% of women of childbearing age in the UK may be iron-deficient, yet only 25% receive a formal diagnosis. Iron is crucial for energy levels, cognitive function, digestion, and immunity. While a balanced diet typically provides sufficient iron, heavy periods can quickly deplete these reserves.
“Women with an iron deficiency get dizzy, suffer from shortness of breath and brain fog, and symptoms can be debilitating,” explains Professor Toby Richards, a haematologist at University College London. “Symptoms are often comparable to – and mistaken for – ADHD and depression.” Professor Richards is advocating for national screening for iron deficiency through his new charity, Shine. A pilot study conducted at the University of East London, screening over 900 women, found that one in three reported heavy periods and 20% had anaemia. Notably, women with iron deficiency were also more likely to report symptoms of depression.
Finding Relief and a Call for Change
Now, at 42 and a mother of two, Emma Cleary has finally found relief with a private prescription for tranexamic acid and annual iron infusions. “Without it, there’s no way I would have been able to start my own business or be a mum to my two boys,” she says. While the medication is available on the NHS, she notes that her doctors never proactively inquired about her periods.
The Shine pilot study has demonstrated the positive impact of targeted screening, raising awareness and empowering women to take control of their health. “It’s already made a real difference for our students,” says Professor Amanda Broderick, vice-chancellor and president of the University of East London. This growing movement underscores the urgent need for improved awareness, proactive screening, and accessible treatment options for the millions of women silently suffering from the consequences of heavy menstrual bleeding and iron deficiency.
