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The prevalence and impact of heavy menstrual bleeding among athletes and mass start runners of the 2015 London Marathon
  1. Georgie Bruinvels1,2,3,
  2. Richard Burden2,4,
  3. Nicola Brown2,
  4. Toby Richards1,
  5. Charles Pedlar2,3
  1. 1Division of Surgery and Interventional Science, University College London, London, UK
  2. 2School of Sport, Health and Applied Science, St Mary's University, Twickenham, UK
  3. 3Orreco Ltd., London, UK
  4. 4English Institute of Sport, Loughborough, UK
  1. Correspondence to Georgie Bruinvels, School of Sport, Health and Applied Science, St Mary's University, Waldegrave Road, Twickenham, London TW1 4SX, UK; georgie.bruinvels.14{at}ucl.ac.uk

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The single most common cause of iron deficiency anaemia in the developed world in premenopausal females is the menstrual cycle.1 It is well recognised and reported that amenorrhoea and oligomenorrhoea are common in elite athletes typically as a result of relative energy deficiency;2 however, little is known about the prevalence of other menstrual abnormalities. Heavy menstrual bleeding (HMB or menorrhagia) affects a quarter of the general population,3 yet no data exist for athletes or exercising women. It is possible that HMB might impact significantly on women's participation in sport. HMB can lead to fatigue, anxiety, reduced mood and energy levels with a negative impact on quality of life and productivity.4 Furthermore, iron turnover in exercising females …

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