skip to main content

Menstrual Iron Deficiency — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyGastroenterologyMenstrual Iron DeficiencyRACP Adult Medicine

A 40-year-old woman presents with iron deficiency anaemia (Hb 95 g/L, ferritin 10 μg/L). She has heavy menstrual bleeding. Bidirectional endoscopy is normal. Anti-tTG is negative. What is the most likely cause of her iron deficiency?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Iron deficiency from GI blood loss

In a premenopausal woman with iron deficiency and heavy menstrual bleeding, menstrual blood loss is the most common cause. With normal endoscopy and negative coeliac serology, gynaecological assessment is appropriate. Oral iron replacement and management of menorrhagia (hormonal contraception, tranexamic acid) are the mainstays of treatment. Option C best captures this as GI loss is excluded.

Reference: eTG Haematology – 2024 – Iron Deficiency; BSH 2021 Iron Deficiency Guidelines