Iron deficiency (ID) and iron-deficiency anemia (IDA) can affect the health and quality of life of women with heavy menstrual bleeding (HMB).

While anemia is frequently found in this patient group, this review of international guidelines for the management of HMB highlights inconsistencies in the diagnosis and management of IDA, and few guidelines adequately address the need to assess and treat ID.

It is proposed that the principles of patient blood management (PBM) in surgical settings could be applied to optimize the care of women with HMB. Recommendations to correct ID/IDA and treat the underlying cause of the excessive bleeding in patients with HMB reflect the PBM principles to treat anemia before surgery and minimize blood loss during surgery.

More harmonized, “global” consensus guidelines covering all aspects of managing ID and IDA in women with HMB should be developed as an example of good practice for the management of this condition.