Intravenous Iron Leads to Lower Rates of Anaemia in Australia

Introduction: Anaemia is common in otherwise healthy females and the most common cause is iron deficiency often secondary to heavy menstrual bleeding (HMB). Many women (20-40%) may not tolerate oral iron supplementation or it may not work, and intravenous (IV) iron is recommended. In Australia IV iron costs are covered by Medicare and administration is common in primary care. In the UK IV iron predominantly remains a hospital service. We wished to assess the prevalence and treatment of anaemia in otherwise healthy women in Australia compared to the United Kingdom.

Methods: Women aged 15 – 50 were approached at university, sporting and conference events. A validated ‘female health questionnaire’ and a finger prick blood test (HemoCue 801) measuring haemoglobin (Hb) were used to screen. Heavy menstrual bleeding was described as two self-reported symptoms from a 5-point questionnaire and anaemia was defined as Hb <120g/L. Data were analysed to compare the difference between United Kingdom (UK) data and Australian data.

Results: 1937 females were screened at 17 testing events (58-243), 333 were from the UK and 1604 were from Australia. Average age (± SD) was 28.5 (± 9.2) and a third of women (653, 33.7%) reported HMB. Overall, the average Hb was 133.5 ± 12.3 and 219 (11.3%) were anaemic. In the UK 19.22% of women were anaemic (HMB 24.8%, non-HMB 14.4.%) compared to 9.66% in Australia (HMB 9.4%, non-HMB 9.8%) (p<0.001). In Australia, 299/1211 (24.7%) of women had received an iron infusion, none in UK. In the UK women with HMB were more likely to be anaemic whereas in Australia women with HMB were more likely to have received IV iron and overall, those reporting HMB were less likely to be anaemic.

Conclusions: HMB and anaemia are common conditions that affect women in the UK and Australia. We propose that the rates of anaemia in Australia are lower than in the UK due to the accessibility and affordability of iron infusions as a treatment strategy for iron deficiency in Australia compared to the UK.