Research Database -
International Updates

Pregnancy / Menstruation

Issue 30

ESKELAND and colleagues, Department of Public Health and Primary Health Care, University of Bergen Norway conducted a study to evaluate the efficacy of low-dose supplementation of iron with and without a haeme component, prescribed for women in the second half of their pregnancy. METHODS: 90 women participated in a randomised, double-blind placebo controlled trial and were randomised into 3 groups: 1) 31 women received a daily dose of 27 mg elemental iron supplement (Hemofer) containing both haeme and non-haeme 2) 30 women received the same dose as pure non-haeme iron with vitamin C (Collets) and 29 women received placebo. The tablets were masked using a double dummy technique. The women were tested for red cell indices and the iron status markers s-ferritin, s-iron, Total Iron Binding Capacity and red blood cell protoporphyrin through their pregnancy and 8 and 24 weeks after giving birth. Results were analysed according to “intention to treat” principle> RESULTS: The haematological results were equal in the 2 treatment groups. 52% of the women fell below 110 g/l in Haemoglobin (Hb), with only 25% of the women in the supplemented women. No women in the supplemented groups fell below 100 g/l, compared to 14% in the placebo group. Iron status were significantly better for all parameters in the haeme iron group compared to placebo by the end of pregnancy. Within the haeme iron group, there were fewer women with empty iron stores postpartum than at the start of pregnancy (from 14% to 8%). In the non-haeme iron group there was a significant increase from 3% to 27% and in the placebo group the percentage of women with empty iron stores more than doubled, from 21% to 52%. CONCLUSIONS: A daily dose of 27 mg elemental iron with haeme given in the second half of pregnancy prevents depletion of iron stores following birth for most women.
Eskeland B et al. Iron supplementation in pregnancy: is less enough? A randomized, placebo controlled trial of low dose iron supplementation with and without heme iron. Acta Obstet Gynecol Scand 76 (9): 822-8. Oct 1997.

CAMPBELL and colleagues, Hunter Centre for Health Advancement, Wallsend, New South Wales, Australia studied the rates of premenstrual symptoms, treatments tried, perceived efficacy of such treatments, the proportion of women who sought help for premenstrual symptoms, and whether women perceived the need for additional help in dealing with premenstrual symptoms. METHODS: The authors conducted a cross-sectional survey of 310 general practices patients aged 18-45 years who had had a menstrual period in the previous three months. RESULTS: 11-32% of women reported severe or extreme premenstrual changes regarding each of the 10 symptoms on the Premenstrual Assessment Form, with the highest rates for affective symptoms. 85% of the women had tried treatments for premenstrual symptoms, with many having tried a number of treatments. The most commonly tried treatments, reported by at least 1/3 of women, included pain killers, rest, drinking more fluids, and exercise. The most effective treatments reported included dietary changes, evening primrose oil, vitamins including vitamin B6, and exercise. About 50% of the women had sought help, mostly from a GP 45% said that they would like more help to deal with premenstrual symptoms. Higher symptoms scores were associated with a history of endometriosis, lower education level, not taking oral contraceptives, taking evening primrose oil and taking vitamin B6. CONCLUSIONS: There is a real need to further refine programmes and resources and ways to effectively help women with premenstrual symptoms.
Campbell EM et al. Premenstrual symptoms in general practice patients, Prevalence and treatment. J Reperod Med 42 (10): 637-45. Oct 1997.

COMMENTS: This study reveals a rather higher proportion of women who experience severe premenstrual symptoms. These are undoubtedly arising from rather complicated biochemical and hormonal unbalances, which could be treated in many instances with a combination of dietary and hormonal treatment approaches. In the recently held Menopause Symposium hosted by Positive Health, physicians Dr John Lee, Dr Shirley Bond, Dr David Smallbone and herbalist Dr Judy Griffin all outlined clinical programmes which can alleviate many menstrual and menopausal symptoms. Transcripts of the Proceedings will be available soon. Those wishing to order a copy of the Transcripts, please contact Positive Health: Tel: 0117-983 8851 Fax: 0117-908 0097 email: sandra@positive.u-net.com.