Iron deficiency (ID) and iron deficiency anemia (IDA) are very common in women during their reproductive life, but often these conditions remain unrecognized and left untreated.

Heavy menstrual bleeding (HMB) and pregnancy are associated with ID/IDA, influencing health and the physical and social lives of these individuals. Cross discipline expertise has considered evidence presented here of the pathophysiological mechanisms, the symptoms, the diagnostic criteria and the therapeutic approaches to ID/IDA.

A call for action for IDA before and during pregnancy and in the postpartum period is discussed in this review. The uterine disorders causing HMB (which include, but are not limited to uterine fibroids, adenomyosis, endometrial polyps) not only contribute to IDA, but also to infertility and pregnancy complications. It is thus important to reveal and correct ID/IDA. During pregnancy iron requirement increases, thus ID/IDA are common, and these conditions may have a negative impact on pregnancy outcome. Hence, it is critical to early identify and treat ID/IDA during pregnancy with iron replacement therapy. Postpartum IDA may occur following blood loss and major hemorrhage at delivery. In this respect, patient blood management is the best approach for alleviating this critical situation.

Action to increase the awareness for women and physicians on the diagnosis and treatment of ID/IDA is essential to improve health outcomes for women across their life course and for their infants.