Heavy menstrual bleeding (HMB) affects millions of South African women, disrupting their health, quality of life and productivity – but remains underreported and underdiagnosed due to stigma and limited healthcare access.
A recent narrative review in Annals of Medicine & Surgery found HMB affects 10-30% of African women, despite decades of public health efforts, including food fortification and supplementation, that have delivered little reduction in anaemia. Research from African Health Sciences shows over 30% of women with HMB are anaemic, underscoring the serious and often invisible burden borne by women across South Africa and the continent.
HMB is defined as menstrual blood loss exceeding what’s considered normal, often soaking through sanitary products every hour or lasting over a week. Beyond the physical toll, it disrupts emotional well-being and social life. Many women also endure pain, irregular cycles and large clots, yet delay seeking care due to cultural stigma, low awareness and financial hardship.
Key risk factors include hormonal imbalance, uterine abnormalities, infections, poor nutrition and stress. The review also highlights limited access to specialised healthcare, leading to delayed diagnosis and treatment. Daily quality-of-life impacts, such as fatigue, brain fog, anxiety and reduced productivity, are seldom discussed in public conversation despite their profound effect on daily life and work.
A major consequence of HMB is iron deficiency. As women lose more iron each cycle than can be replaced naturally, they develop iron deficiency anaemia. Symptoms like chronic fatigue, weakness, headaches, shortness of breath and brain fog gradually erode concentration, mood and performance in home, work and school settings.
Vanessa Ascencao, health and wellness expert, explains that women with heavy periods, fatigue or anaemia symptoms should consult healthcare professionals. She cautions, however, that many frontline clinicians may not fully recognise HMB. Women can proactively request iron testing (including ferritin) and referrals to specialists when needed. Additionally, she encourages women to adopt lifestyle measures such as balanced nutrition, stress management and, where appropriate, the use of natural, clinically proven iron supplements.
Ascencao recommends Spatone, a naturally sourced iron rich water from Snowdonia, Wales. This scientifically backed, gentle supplement is easy on the stomach and highly absorbable, without common side effects like constipation or nausea. With regular use, Spatone supports healthy iron levels and helps reduce fatigue, restoring natural energy so women can feel their best every day.
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