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Study under review: The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes
Though it’s not openly discussed very often, heavy menstrual bleeding (HMB) affects roughly a quarter of the female population and can have a negative impact on physical performance and general quality of life.
Assessing the true impact of HMB is difficult due to the lack of standardized and objective diagnostic measures. Definitions can include blood loss of more than 80 ml per menstrual cycle, or subjective measures like excessive menstrual blood loss that interferes with a woman’s physical, social, or emotional quality of life. Different studies have defined the condition as including two or more of the following criteria: passing of large blood clots, need for double sanitary protection, need for frequent (every two hours or less) changes of tampons and towels, the need for 12 or more sanitary items per period, and flooding through to clothes or bedding.
Regardless of the definition, increased menstrual blood loss will increase a woman’s risk of iron deficiency, and in turn, iron deficiency anemia. Iron is an essential mineral with roles in numerous biological processes including oxygen transport and energy production. Menstrual bleeding, particularly when it is heavier than normal, is the most common cause of iron deficiency anemia in women of childbearing age. Accordingly, a recent observational study found that 63% of women with HMB reported being deficient in iron at some point.
Due to its important roles in oxygen transport and energy production, poor iron status can have a profound impact on endurance exercise performance. Figure 1 shows exercise-related factors that compound the risk of anemia in menstruating athletes, namely increased iron loss through the GI tract, sweat, and foot strike hemolysis (destruction of red blood cells from the repeated shock and impact of long distance running).
The prevalence and impact of HMB in females who exercise has yet to be determined. The aim of this current observational study was to determine the prevalence of HMB in exercising females, determine if it correlated with level of athletic performance, and better understand the perceptions of HMB among female athletes.
Heavy menstrual bleeding affects approximately 25% of women, and can have detrimental effects on iron status, and, in turn, endurance performance. The purpose of this study was to examine the prevalence and impact of heavy menstrual bleeding in elite and recreationally active females who exercise.
Other Articles in Issue #21 (July 2016)
Interview: Norm Robillard, PhD
Gut health is extremely variable and complex, so learning from experts is important. Norm is a microbiologist whose expertise lies in the effect of diet on gut conditions.
Let the sun shine in! (to your retinal ganglion cells)
We've covered the detriments of night-time blue light before, but how important is getting blue light during the work day? This controlled trial looked at its effect on working memory.
How can researchers figure out the role of your genetics in determining the kinds of bacteria you have in your gut? Get over a thousand sets of twins and do some fancy testing. We describe the results here.
Dampening exam anxiety with probiotics
When you're stressed out for an exam, you probably don't instinctively reach for probiotics. Your microbiome may impact anxiety though, and this trial tested a probiotic for anxiety-lessening around exam time.
Probiotics and prebiotics for atopic dermatitis
This meta-analysis looked at all the existing trials on the common type of eczema called "atopic dermatitis", to see if combining pro- and prebiotics helps reduce symptoms.
Potential relief for IBS through vitamin D
Vitamin D isn’t just for bone health. Its role in dampening inflammation and regulating immune responses suggest that it may help in treating IBS, which is directly tested in this randomized trial.
Interview: Elle Penner, MPH, RD
Elle is the senior dietitian at the nutrition and fitness tracking juggernaut MyFitnessPal. We discuss some tips for new moms thinking about diet considerations.
Fish oil showdown: anti-inflammatory effects of EPA vs. DHA
Chronic inflammation is a driver of many health conditions, and plays a key role in heart disease. Fish oil is a popular supplement partly due to its potential anti-inflammatory actions. But which omega-3 has a greater impact, EPA or DHA?
Could fasting help treat MS symptoms?
Multiple sclerosis involves immune attacks on the nervous system. Current treatments address symptoms, but may have substantial side effects. Fasting diets may both help symptoms and regeneration of existing damage.