Heavy menstrual bleeding is one cause of anaemia. - Contributed

There are many causes of anaemia. In Jamaica, the condition is often associated with heavy menstrual bleeding in women.

Anaemia is the condition in which the blood cannot carry enough oxygen to meet the needs of the body. This may be because there are less red blood cells than normal, or because there is not enough haemoglobin, the oxygen-carrying component of red blood cells, in each cell.

Either of these conditions can arise in women who have heavy periods each month.

Symptoms of anaemia include feeling tired or faint and getting breathless easily. Other symptoms include tiredness, dizziness, rapid, weak pulse or palpitations, and headache. People with anaemia may also look pale. Treatment depends on what is causing the anaemia.

According to Kingston-based gynaecologist Dr. Monique Rainford, "Normal bleeding and heavy bleeding is a common problem."

The presence of anaemia, she says, depends on how extensive the blood loss is.

"If they get very anaemic, besides getting iron supplementation, some women may also require transfusions," she states.

Causes

Researchers note that there are many possible causes of anaemia. The body may not be producing enough red blood cells to replace those that are destroyed. This can occur when the body lacks some of the substances that it needs to manufacture them, such as iron.

Iron deficiency is the most common cause of anaemia. Most individual's diet contains enough iron, but at times the body may need more because it needs a larger supply of blood than usual. This is, for example, during a growth spurt in childhood or during pregnancy.

Blood is made up of fluid called plasma which contains three types of cells:

White blood cells - These are part of the immune system, the body's defence against infection.

Platelets - These are involved in blood clotting.

Red blood cells - These carry oxygen around the body in a pigment called haemoglobin. The main component of haemoglobin is iron.

Red blood cells are made by the body in the bone marrow, and live for around four months before they are destroyed and replaced, as part of a normal renewal process. Other vitamins that are needed to manufacture red blood cells include folate (folic acid) and vitamin B12. A lack of these in the diet can cause anaemia.

Losing too many red blood cells can also be a cause of anaemia. This results from bleeding, for example excessive menstrual bleeding, bleeding from the gut (which may go unnoticed and pass out in stools), or major surgery.

Blood cell problems

Anaemia can also be caused by red blood cell problems:

Thalassaemia - A genetic disorder in which haemoglobin is not correctly formed.

Sickle-cell anaemia - A genetic disorder in which the red blood cells are crescent-shaped rather than round and cannot carry oxygen as well as normal red blood cells.

Haemolytic anaemia - A condition in which red blood cells are fragile and can get broken easily in the bloodstream.

Red blood cell production can also be suppressed by treatments for cancer, including chemotherapy and radiotherapy.

Problems with bone marrow and leukaemia can also cause anaemia. Other medical conditions that can result in anaemia include kidney failure and rheumatoid arthritis.

Treatment for anaemia depends on its cause. For many people, treatment involves taking iron tablets or supplements of folic acid or vitamin B12. For some people, treatment is aimed at dealing with the underlying cause and so is more complex.

Researchers note that the best way to prevent anaemia is to eat a healthy, balanced diet. The main sources of the nutrients you need to make healthy red blood cells are:

Iron: Meat, liver, cereals, raw green vegetables, fortified foods such as some breakfast cereals.

Vitamin B12: Meat, shellfish, milk, cheese, and eggs. It is not found in any vegetable.

Folate: Raw green vegetables, oranges, wholegrain cereals, some fortified foods such as breakfast cereals and bread.

Information sources: www.vitaminuk.com and www.bupa.co.uk/health