Misbeliefs about menstruation add to Kerala’s anaemia burden


It’s the most common nutritional problem among children, adolescents and women

The Journal of Clinical Practice, the new online journal of the Indian Medical Association, reported the case of a woman with severe anaemia in its latest edition.

The 48-year-old woman, from near Kochi, had presented herself in the cardiology department for breathlessness. Except for a higher body mass index, the woman did not have any co-morbidities. Her echo test results were normal, but when the blood test results came in, she had haemoglobin levels at 5.4 gm per decilitre of blood as against the normal range of 12-15 gm.

In a detailed gynaecological reference, it was revealed that she had severe monthly menstrual blood loss of around 200 ml compared to the normal 50-80 ml. So, over a period of one year, she had developed anaemia due to abnormal uterine bleeding.

A scan showed bulky uterus with adenomyosis, a condition that causes excessive menstrual bleeding. Anaemia was corrected with iron sucrose injections and a hysterectomy was done. This was reported by gynaecologist Smithy Sanel. Dr. Sanel said many women think it was impure blood that was lost during menstruation and hence considered it good if there was heavy loss. While women in the State were literate and knew many things, health-related issues continued to be looked at with religious lenses. In this case too, the woman was educated and from an upper middle class family, Dr. Sanel said.

Health education

Children should be given health education right from the upper primary age and adolescent girls should know everything about menstruation, said Dr. Sanel.

“During classes for young girls, we understand that perceptions on menstruation is thoroughly misguided. Most girls knew little about various health aspects even though they might be postgraduates in their subjects. Literacy has not added to overall knowledge in the community,” she said

Dr. Sanel who is also the chairperson of the adolescent health committee of the Kerala Federation of Obstetric and Gynaecology said plans were afoot to conduct a school-level survey for better health education, including tackling anaemia and menstrual health. Both are connected as any abnormality in menstrual flow could affect the woman’s health, she added.

Anaemia has been found to be higher in young girls and those past the pregnancy age, as there is little awareness of eating well that could give the body the necessary iron. Anaemia was cured in pregnant women because of the good ante-natal care in the State, said Zareen Algiers, secretary of the Cochin Gynaecology Society. Unless severe anaemia caused some symptom, it remained undetected in the population, she said. In private practice, about 10% cases presented were found to be anaemic and in government sector about 30% cases were anaemic, she added. Anaemia had been a concern for long. But little is done in this regard.

The recent NFHS 4 says that about 40% women in the population are mildly anaemic, 12% are moderately anaemic and 1% severely anaemic. Anaemia has been identified as the most common nutritional problem affecting children, adolescents and women.

The prevalence of anaemia in the population, however, was unclear, said P.S. Rakesh, Kerala consultant, WHO.

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Printable version | Dec 11, 2019 7:52:20 AM |

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