Causes and consequences of iron deficiency without anemia in the practice of gynecologist

Authors

  • T. F. Tatarchuk SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”
  • N. V. Kosei State Institution “O.M. Lukyanova IPOG of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine" http://orcid.org/0000-0002-5498-4143
  • N. F. Zakharenko SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” http://orcid.org/0000-0003-2934-3157
  • K. S. Pavlova SI “O.M. Lukyanova IPOG of the NAMS of Ukraine” http://orcid.org/0000-0003-2961-456X

DOI:

https://doi.org/10.18370/2309-4117.2020.56.13-17

Keywords:

iron deficiency, anemia, ferritin, transferrin, abnormal uterine bleeding, oral iron preparations, iron bisglycinate, tolerance

Abstract

The effect of iron deficiency (ID) without anemia on the reproductive health of women in contrast to iron deficiency anemia is still insufficiently evaluated from a clinical point of view, despite a weighty theoretical basis and a large pool of clinical observations. The purpose of this review is to systematize the ID causes without anemia in women associated and not associated with reproductive disorders, the effects of ID without anemia on reproductive health, and modern approaches to the diagnosis and treatment of this pathology. ID without anemia affects most of the physiological processes in a woman's body, including hormonal regulation, immune processes and functions of the nervous system. The negative effect of ID without anemia on a woman's reproductive function is realized through hormone-mediated and immune mechanisms. ID without anemia is currently underestimated in terms of somatic and reproductive health of women, as well as quality of life. Сlinical manifestations of ID without anemia are mostly nonspecific, which is why clinicians, focusing only on hematological parameters are often explaining them by other reasons, which leads to late diagnosis. Assessment of hematological parameters alone is accompanied by significant underdiagnosis of ID without anemia. Diagnosis of ID without anemia should be carried out in women with risk factors (abnormal uterine bleeding, heavy menstrual bleeding, etc.), as well as with dyshormonal disorders, recurrent inflammatory processes in combination with ID symptoms by assessing the ferritin and transferrin saturation.

To treat ID without anemia it is necessary to eliminate the etiological factor and carry out a sufficiently long-term supplementation with oral iron preparations with good tolerance and bioavailability. Iron bisglycinate is the form of iron intake that does not affect the mucous membrane of the gastrointestinal tract and is absorbed by the small intestine mucosa unchanged, which ensures its good tolerability and high efficiency for the correction of ID.

Author Biographies

T. F. Tatarchuk, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine”

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, head of the Endocrine Gynecology Department;

chief researcher, Department of Reproductive Health

N. V. Kosei, State Institution “O.M. Lukyanova IPOG of the NAMS of Ukraine”; State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine"

MD, professor, chief researcher, Endocrine Gynecology Department;

leading researcher, Department of Reproductive Health 

N. F. Zakharenko, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

MD, chief researcher, Endocrine Gynecology Department

K. S. Pavlova, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”

Obstetrician gynecologist, graduate student, Endocrine Gynecology Department,

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Published

2020-12-29

Issue

Section

Gynecology