Iron deficiency and iron deficiency anaemia in women of reproductive age: Sex- and gender-based risk factors and inequities

Iron deficiency (ID) is a serious public health problem that affects 20–25 % of the population and 52 % of pregnant people worldwide. Biologically female women (women) of reproductive age have a higher risk of developing ID due to the increased physiologic demand for iron required to support menstruation and pregnancy. If left untreated, ID can develop into iron deficiency anaemia (IDA), which affects one in three women between the ages of 15–49 years worldwide. Among women of reproductive age, those who are pregnant have the highest risk of developing ID and IDA due to increased iron requirements to support pregnancy and the developing fetus. Despite the high prevalence of ID and IDA, it remains underdiagnosed in reproductive-aged women and current treatment options are not well accepted. There is an urgent need to investigate novel strategies to ensure adequate iron status in women of reproductive age to prevent adverse health problems and promote healthy pregnancies. This review explored the critical role of iron in women's health by examining iron requirements throughout the lifespan, the physiology of iron absorption, factors affecting iron bioavailability, and the causes of ID and IDA. We discuss the limitations of current interventions for ID and IDA, and the need to develop effective and widely acceptable treatments for these conditions, particularly in women of reproductive age. The findings of this review suggest that current interventions for ID and IDA are inadequate and that sex biases exist in the diagnosis and management of ID and IDA in biologically female women.