Structural Sexism and Gender Disparities in Anemia Management

SUMMARY

Systemic Underdiagnosis and Research Gaps: Women’s anemia is often normalized or overlooked, compounded by diagnostic thresholds and clinical research historically based on men. This leads to under-recognition of women’s unique risk factors and treatment needs.
Health and Social Consequences: Unrecognized anemia in women increases risks for cardiovascular disease, cognitive decline, and poor mental health, while cultural and economic barriers limit access to testing, nutrition, and therapy.
Call to Action: Public health strategies must adopt gender-sensitive criteria, targeted screening, and equitable access to iron supplements and nutrition education.

Normalization Of Anemia in Women

Symptoms of anemia in women are often dismissed as “normal,” especially when related to menstruation or postpartum fatigue, leading to widespread underdiagnosis and undertreatment.

Diagnostic Limitations

Traditional diagnostic thresholds were based largely on male populations, contributing to under-recognition of anemia in women.

Long-Term Risks of Unrecognized Anemia

Mild to moderate anemia can increase the risk of cardiovascular disease, cognitive decline, and poor mental health outcomes when left untreated in women.

Research Bias

Most clinical trials have centered around male physiology, leaving gaps in understanding how women uniquely experience and respond to iron deficiency and treatment.

Overlooked Causes in Women

Factors like menstruation, fibroids, pregnancy, and postpartum blood loss are often not sufficiently addressed in standard anemia workups or management plans.

Barriers to Care

Women may face cultural, social, and economic obstacles that limit access to iron-rich foods, diagnostic testing, and appropriate therapy.

Public Health Recommendations

Strategies to reduce the burden of IDA in women should include:

Gender-sensitive diagnostic criteria
Targeted screening in high-risk groups
Access to affordable iron supplements
Nutrition education and support programs

Reference

Weyand, A. C., & James, P. D. (2020). Sexism in the management of bleeding disorders. Research and practice in thrombosis and haemostasis, 5(1), 51–54. https://doi.org/10.1002/rth2.12468
Weyand, Angela C, et al. “Sex Specific Definitions of Anaemia Contribute to Health Inequity and Sociomedical Injustice.” The Lancet Haematology, vol. 9, no. 1, Jan. 2022, pp. e6–e8, https://doi.org/10.1016/s2352-3026(21)00351-3.
Jefferds, M. E. D., Mei, Z., Addo, Y., Hamner, H. C., Perrine, C. G., Flores-Ayala, R., Pfeiffer, C. M., & Sharma, A. J. (2022). Iron Deficiency in the United States: Limitations in Guidelines, Data, and Monitoring of Disparities. American Journal of Public Health, 112(S8), S826–S835. https://doi.org/10.2105/ajph.2022.306998
Mei, Z., Addo, O. Y., Jefferds, M. E., Sharma, A. J., Flores-Ayala, R. C., & Brittenham, G. M. (2021). Physiologically based serum ferritin thresholds for iron deficiency in children and non-pregnant women: a US National Health and Nutrition Examination Surveys (NHANES) serial cross-sectional study. The Lancet Haematology, 8(8), e572–e582. https://doi.org/10.1016/S2352-3026(21)00168-X