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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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