Abstract
During the course of iron balance studies on patients with hypochromic anemia, the amount of blood lost during menstruation was determined on several occasions. The figures obtained were surprisingly high but since no uniformity of opinion exists as to the normal menstrual loss an analysis of this was made on 50 women. The individuals selected were for the most part members of the hospital staff whose ages ranged from 19 to 43 years, who had no known menstrual disorders and whose blood hemoglobin was at least 75% of normal (10.2 gm. per 100 cc.).
Cellulo cotton pads were used in most cases although in a few instances a vaginal cup was utilized for the collection of the menstrual flow. This was analyzed for iron by a modification of the method of Reis and Chakmakjian, 1 and the result interpreted in terms of grams of hemoglobin on the assumption that this iron was derived entirely from hemoglobin.
Blood hemoglobin determinations were made on all subjects several days after the menstrual period to avoid variations that may occur because of changes in the water balance and the consequent hydremia. These values ranged from 10.200 to 13.190 gm. per 100 cc. of blood.
The iron loss in these 50 individuals with supposedly normal menstrual periods varied from 3.84 to 78.4 mg. per period. This represents from 1.146 to 23.403 gm. of hemoglobin. If this is expressed in terms of cubic centimeters of blood, calculated in each instance from the patient's own hemoglobin content in grams per 100 cc., it represents a loss of 9.39 to 207.28 cc. with a mean of 36.7 cc. of blood per menstrual period. Much larger amounts of iron and hemoglobin were lost by the patients with hypochromic anemia even though they considered their menstrual periods to be entirely normal.
The loss of 78.4 mg. of iron at each menstrual period would necessitate a daily iron retention of approximately 2.8 mg. to replace that lost by menstruation alone.
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