Investigation and Management of Iron Deficiency Anemia in Non-pregnant Reproductive-Age Women: A Retrospective Analysis

Background Iron deficiency anemia (IDA) is the leading cause of anemia worldwide, disproportionately affecting women of reproductive age due to heavy menstrual bleeding (HMB). Although international guidelines emphasize baseline ferritin and hemoglobin measurement, treatment with oral or intravenous (IV) iron, and appropriate follow-up, gaps persist in practice. In the UAE, where prevalence remains moderate but clinically significant, evaluating adherence to evidence-based standards is critical. This study assessed compliance with international IDA guidelines at a private hospital in Dubai. Methods A retrospective chart review was conducted for non-pregnant women of reproductive age presenting with suspected IDA between January and June 2025. Data was collected on diagnostic testing, documentation of menstrual history, identification of underlying causes, treatment modality, and follow-up. Frequencies and percentages were calculated for categorical variables, while medians and interquartile ranges were reported for continuous data. Independent t-tests were performed to assess differences in hemoglobin and ferritin levels between patients with and without HMB, as well as to evaluate differences in treatment response between oral iron and IV iron. A t-test was applied, and a p-value ≤ 0.05 was considered statistically significant. Results Ninety-three patients were included. Hemoglobin was documented in 91.4% and ferritin in 86%. Only 41.9% met the diagnostic threshold of Hb <12 g/dL and ferritin <30 µg/L. Menstrual history was documented in 72%, but underlying causes such as HMB were addressed in 36.6%. Oral iron or Intravenous iron with appropriate justification was prescribed first-line in 86.0%, while IV iron use was justified in 80% of cases. Follow-up hemoglobin testing within the recommended timeframe was completed in only 15.1%. Conclusion High compliance was observed for initial investigations and oral iron prescribing, but shortfalls were identified in diagnostic accuracy, documentation of menstrual history, evaluation of underlying causes, and follow-up.