Anaemia is defined as a condition suffered by an individual where the hemoglobin is grossly below the normal level. A haemoglobin of less than 8 can be graded as severe anemia. Types of anemia include:
- Iron deficiency
- B12 deficiency
- Haemolytic anemia
Anaemia can be encountered as early as the neonatal period up to the geriatric age. Dr Ranjana Vilas Dhanu, Consultant- Obstetrician Gynaecologist, Infertility Specialist, Endoscopic Surgeon, and Robotic Surgeon explains, “In the neonatal age, anemia could be due to errors of metabolism like hemolytic diseases of the newborn or certain digestive gut disorders with ulcerations like ulcerative colitis which can develop into Crohn’s disease. Due to the daily loss of blood through tiny ulcers in the gut, the newborn can have severe anemia and needs proper correction of the underlying condition by arresting the hemorrhage through medical management and correction of the hemoglobin.”
Childhood Anaemia and Malnutrition
Dr Ranjana adds, “In childhood, we have a huge challenge of tackling malnutrition and worm infestation in the rural population. While malnutrition is a highly deficient intake of an iron-rich diet, worm infestation leads to blood loss through the gut.”
As mentioned earlier, certain in-borne errors of metabolism can continue through childhood as well as Crohn’s or Ulcerative colitis.
Adolescent Anaemia: PCOS and Menorrhagia
“In teenage girls, we do see a remarkably high risk of Polycystic ovary syndrome (PCOS) associated with adolescent obesity and irregular periods leading to puberty menorrhagia. Such girls manifest chronically irregular periods with periods of amenorrhea, which is the absence of periods for 3 to 4 months following which they blood for 3 to 6 weeks with the passage of clots. This immediately needs hormone correction, arrest bleeding, and iron supplementation to replenish the iron to the normal physiological levels, that is, 12 grams/decilitre,” Dr Ranjana further highlights.
“PCOD can also manifest throughout the lifespan of a woman with irregular heavy menses. As mentioned, endometrial hyperplasia(thickening of the uterine wall), endometrium collapse, or post-menopausal bleeding.”
Anaemia in Middle-aged Women: Fibroids and Adenomyosis
Dr Ranjana says, “In middle-aged women between 30 – 45 years, the patients seen in the OPD with the most common cause of heavy bleeding attributed to fibroids or adenomyosis. Fibroids are seen in 70% of the female population, 50% of which manifest with different symptoms, anemia being the commonest. Fibroids depending on their location, can contribute to anaemia due to heavy blood loss. It may or may not be associated with the correction of severe anaemia with tablets, diet, IVIN, and blood transfusion (if necessary) are the common modes of treatment.”
Common Causes of Anaemia Across All Ages
Besides gynecological causes, bleeding constipation and piles are some of the most common conditions encountered at all ages. If bleeding constipation is not treated, it can develop into fissures or piles with bleeding per anum at all ages.
Anaemia in Pregnancy and Postpartum Period
Certain physiological conditions like pregnancy are conditions where there is a sudden demand for haemoglobin by the foetus on the mother and it is mandatory to perfunctorily support the mother with iron supplements and a diet rich in iron through pregnancy and later. Women pot-partum are educated about contraceptive measures to prevent unwanted pregnancies, abortions, and further blood loss.