Heavy menstrual bleeding is one of the main risk factors for iron deficiency anemia (IDA). In fact, in one study, 40% of US females aged 12-21 were found to have iron deficiency, and 6% had IDA. Similar prevalence exists in Ontario, Canada, where 38% of females aged 15-54 were found to have non-anemic iron deficiency and 13% had IDA. Notably, there is a strong correlation between low socioeconomic status and prevalence of anemia. 

Why does this matter? Does iron deficiency matter if you are not anemic? 

Symptoms of iron deficiency (e.g. generalized weakness, poor concentration, depression, insomnia, reduced cognition) often precede the development of anemia. Anemia is a late-stage complication of iron deficiency. 

Heavy menstrual bleeding is very important to diagnose and treat to prevent the development of non-anemic iron deficiency and IDA.