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Anaemia Among Menstruators Is Easily Preventable And Treatable By Following These Steps

What is anaemia?

Anaemia is an indicator of both poor nutrition and poor health. It is a condition of the blood that occurs when the number and size of red blood cells is insufficient. Red blood cells contain the iron-rich protein haemoglobin, which is necessary for transporting oxygen from the lungs to the cells and tissues. When your haemoglobin concentration falls, the oxygen-carrying capacity of the blood decreases, resulting in symptoms such as fatigue, reduced physical work capacity and shortness of breath, among others.

What is the most common form of anaemia?

Iron-related anaemia is the most widespread nutritional disorder in the world and causes about 50% of anaemia cases. Women are at a greater risk of becoming iron deficient because they have much lower iron stores than men and incur additional iron losses during menses. Adolescent girls or women who become pregnant have a significantly higher need for iron during pregnancy, which can substantially increase risk of iron deficiency anaemia.

What are the signs and symptoms of anaemia?

Anaemia can range from mild to severe with a range of signs and symptoms. Some common symptoms of anaemia include fatigue, weakness and difficulty in concentrating, brittle or spooned nails, pale skin, cracks at the sides of the mouth, coldness in the feet and hands, shortness of breath.

Iron and Folic Acid Supplementation programme in progress in school. Image has been provided by the author.

How does anaemia impact adolescents?

Anaemia reduces energy levels and can compromise the work potential of a person. As a result of anaemia, adolescents may face decreased school performance and loss of productivity. It can also have negative reproductive outcomes for an adolescent mother and her infant.

 What are the ways of preventing anaemia in adolescent girls?

In addition to taking weekly iron and folic acid supplementation (WIFAS), simple steps such as consuming iron-rich diets, adopting healthy eating practices, consuming staple foods which are fortified with iron, and being physically active, can all help in keeping anaemia at bay.

Clarifying Queries On Iron And Folic Acid Supplements

What are iron and folic acid supplements? 

Iron and folic acid supplements or IFAs are oral supplements recommended by the World Health Organisation as a preventative public health intervention for adolescent girls and menstruating women living in areas where the prevalence of anaemia in adolescent girls and women of reproductive age (WRA;15-49 years of age) is 20% or greater. Weekly iron and folic acid supplementation (WIFAS) is a strategy adopted to ensure regular and wide consumption of iron among those who are most vulnerable to anaemia.

 Why are WIFAS important for adolescent girls?

Adolescence is the period with the second highest rate of growth in a person’s life, second only to infancy. A human being has greater nutritional needs during puberty than any other period of life. One much-required nutrient is ‘iron’, which is needed for expanding blood volume, development of lean body mass, as well as counteracting menstrual blood loss in females. Through iron folic acid supplementation, adolescent girls can get their required quantities of iron, which can help prevent and reduce anaemia.

Is it safe to consume IFA by adolescents?

Yes, IFA are safe to take once a week.

Is it safe to consume weekly IFA over long time periods?

Yes, it is safe to consume weekly IFAs over long and/or multiple time periods. The current weekly formulation is well below the weekly upper limits set by the institutes of medicine.

Are there any side effects associated with WIFAS?

There are some side effects associated with WIFAS, which may include black stools, nausea, constipation, abdominal cramping and vomiting. However, these side effects are typically reported only in the first few weeks and normally decrease over time.

How can the side effects be managed?

Side effects have been most associated with taking the supplement on an empty stomach. Thus, to reduce the chances of side effects, it is best to take the supplement within two hours of consuming a meal.

Do WIFAS help regulate menstruation?

Girls who are underweight and gain weight may experience increased regularity in menstruation or return of menstruation if periods were absent. However, there is currently no evidence that links iron supplementation with improving or influencing menstruation.

Should we screen for anaemia before starting WIFAS?

Since WIFAS is a preventive strategy, adolescents need not be tested prior to receiving weekly supplements. However, it is advisable in case one presents signs and symptoms of anaemia, they should be referred to a local health centre for follow-up, to be assessed and given treatment as appropriate.

Is WIFAS for treating anaemia?

WIFAS is a public health strategy recommended by the World Health Organisation that has been adopted in many nations to prevent anaemia among adolescent girls and pregnant women. It is not a treatment procedure given to a person identified with symptoms of anaemia.

What happens if a girl does not take IFA?

Girls do not need to be or appear sick in order to take WIFAS, as it is not a treatment for anaemia and is only a preventive strategy. All girls without any specific medical conditions are recommended to take WIFAS as a preventive measure against anaemia and its negative consequences. While taking WIFAS is completely voluntary, if a girl chooses not to take the supplement, she may be at a higher risk of anaemia and its associated consequences.

What are the common myths associated with IFA tablets?

Some women and girls refrain from taking IFA tablets as they think they will get fat or have problems in conceiving. Many pregnant women also believe that consuming IFA during pregnancy will result in the birth of a dark-complexioned child. However, all these are myths and must not be believed.

Are IFAs a contraceptive?

No, IFA is not a contraceptive. The formulation contains iron and folic acid that are not contraceptive agents. A girl can still become pregnant while taking IFA supplements as it is neither a reproductive tool nor a family planning method.

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