What is Anaemia? 

Anaemia is a medical condition wherein a person’s red blood cells (RBCs) and oxygen-carrying ability falls short of meeting the body’s physiological needs. The RBCs’ function is to deliver oxygen from the lungs to the tissues and also carry carbon dioxide to the lungs from the tissues. This is achieved with the help of haemoglobin (Hb), which is a tetramer (a structure with four subunits) protein made from haem and globin. 

Anaemia can occur if there are too few red blood cells, if there are abnormal RBCs or if the haemoglobin level of the RBCs is below the normal range. Anaemia can range from mild to moderate to severe and can be a temporary or permanent (chronic) issue. The World Health Organisation has stated that the estimated global anaemia prevalence is around 56%

Anaemia in Women 

Women, especially, are highly susceptible to developing anaemia because of nutritional deficiencies, poor absorption and other chronic conditions.- They also lose blood during menstruation every month. Worldwide, the most common type of anaemia affecting women is iron deficiency anaemia. According to a report conducted by the National Family Health Survey, it was found that anaemia was prevalent in about 57% of women aged between 15-49 years in India. 

To understand what causes anaemia in women and how to identify and manage it, let us keep reading below. 

Symptoms of Anaemia in Women

While it is common to feel tired after a long day, women who are anaemic usually feel extremely fatigued post shorter periods of exertion. This happens because there is enough blood carrying oxygen to different parts of the body. As your condition aggravates, you are likely to experience other symptoms, such as breathlessness and pale skin. So, some possible signs of anaemia that you need to look out for are:

• Weakness 
• Tiredness
• Shortness of breath 
• Yellowish or pale skin (becomes more pronounced in people with fair to wheatish complexion)
• Irregularity in heartbeat 
• Lightheadedness or dizziness 
• Cold hands and feet 
• Frequent headaches 
• Difficulty in concentrating on a task 
• Irregular periods

If the cause of anaemia is iron deficiency, some other symptoms are:

• Brittle nails 
• Inflamed or sore tongue
• Unhealthy cravings for non-nutritive substances such as starch, ice or clay
• Poor appetite

What are the Causes of Anaemia?

Not all forms of anaemia in women can be attributed to the same cause. Therefore, the different reasons include:

• Iron deficiency 

The body’s iron needs are fulfilled from dietary sources or through supplements. Iron deficiency can occur due to –

1. Insufficient intake of dietary iron
2. Poor absorption of iron from the digestive system

• Inflammation

Ongoing inflammation caused by diseases such as autoimmune disorders, HIV/AIDS, kidney disorder, rheumatoid arthritis and Crohn’s disease suppresses the body from making sufficient red blood cells in women. This condition is also known as anaemia of chronic disease. 

• Vitamin deficiency 

A diet not rich in vitamin B-12 and folate aside from iron keeps the body from making healthy red blood cells. 

• Aplastic anaemia 

This is caused due to disorders of bone marrow. This type of anaemia is often associated with a reduced count of other blood cells like WBCs and platelets. , 

•  Cancers

Disorders such as myelofibrosis and leukaemia affect how the bone marrow makes blood. There can be a reduction of healthy blood cells or an overproduction of abnormal blood cells.

• Sickle cell anaemia

This is a serious and inherited condition where the red blood cells attain an unusual crescent shape like that of a sickle. The irregular blood cells die sooner than usual and this sets into motion continuous red blood cell insufficiency. The prevalence rate for sickle cell anaemia is particularly high amongst tribal women in India. 

• Hemolytic anaemia 

This is caused when the red blood cells are destroyed faster than the rate at which they can be replaced by the bone marrow in women. 

What are Some Complications Associated with Severe Anaemia in Women?

Severe and often unaddressed iron deficiency anaemia in women causes the following health problems:

• Severe fatigue
• Poor productivity 
• Inability to exercise regularly 
• Enlarged heart (cardiomegaly) or heart failure
• Greater propensity to catch infections 
• Adverse foetal and maternal outcomes (during pregnancy)
• Risk of birth defects  in children who are born to iron-deficient mothers

Treatment for Anaemia 

Treatment for anaemia first begins with an accurate diagnosis. Once your condition is identified, the doctor will prescribe medications and suggest lifestyle changes, mainly in the form of dietary measures to stabilise your health. 

Diagnosis:

This will involve undergoing a string of blood tests which includes a complete blood count (CBC). To evaluate if an individual is anaemic due to iron deficiency, additional tests may also be ordered. These are: 

• Iron-binding capacity test – Measures the ability of the body to attach itself to iron and carry it around the body
• Ferritin test – Ferritin is a blood protein containing iron. The test evaluates the quantity of ferritin in the blood
• Serum test – Measures the quantity of protein that is contained in the liquid portion of blood
• Peripheral smear test- This examines red and white blood cells and platelets under the microscope.

In the event that iron deficiency anaemia is diagnosed by the healthcare provider, they will suggest some additional testing which can be as follows:

• A faecal occult blood test examines if there are any traces of blood in the stool
• Examining if there is any presence of abnormalities in the gastrointestinal tract- endoscopy, capsule enteroscopy, barium swallow, barium enema or small bowel biopsy
• Urine test 
• Bone marrow biopsy
• In women with unusually high levels of menstrual blood loss, the doctor can recommend a gynecologic evaluation such as uterine biopsy or pelvic ultrasound.

Medication:

Prescribed medications include iron and other vitamin supplements. 

In severe cases, doctors may prescribe medications to promote red blood cell production, such as immunosuppressants or erythropoietin injections. If the haemoglobin level is abnormally low, then the doctor may also suggest blood transfusions to treat anaemia. 

Dietary Measures 

To treat iron deficiency anaemia in women, the doctor can suggest the following dietary measures:

• Consumption of organ meats such as liver (only for non-vegetarian patients)
• Poultry such as chicken and eggs (only for non-vegetarian patients)
• Fish rich in omega-3 fatty acids 
• Leafy greens 
• Greater intake of legumes 
• Iron-fortified whole grains and cereals 
• Iron supplements

Importance of Identifying and Managing Anaemia in Women 

• Opting for more iron-rich foods such as beans, seafood, poultry, dark leafy greens, dried fruits (apricots, raisins), peas and iron-fortified pasta and rice.
• Consuming a greater quantity of vitamin-C-enriched foods such as oranges, grapefruit, tomatoes, melons, and kiwis enhances the level of iron absorption in the body. 
• If an expecting mother has been diagnosed with iron deficiency anaemia, you should feed your infant with special iron-fortified formula or breast milk. 

Conclusion:

Untreated anaemia can adversely affect a woman’s productivity and quality of life. Proper awareness with respect to symptoms coupled with regular visits to the doctor (haematologist) with a complete blood count profile is a necessity. Additionally, you must ensure to strictly adhere to a healthy diet rich in protein, iron and vitamin C. Keep a tab on your haemoglobin levels and iron profiles if you have been diagnosed with any type of anaemia. 

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