Iron deficiency therapy in aesthetic gynecology: current paradigms
- Authors: Apolikhina I.A.1,2, Efendieva Z.N.3, Serov V.N.1
-
Affiliations:
- Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- MOSITALMED International Medical Center
- Issue: Vol 33, No 4 (2026)
- Pages: 138-144
- Section: Obstetrics/gynecology
- Published: 17.08.2026
- URL: https://journals.eco-vector.com/2073-4034/article/view/717306
- DOI: https://doi.org/10.18565/pharmateca.2026.4.138-144
- ID: 717306
Cite item
Abstract
Iron deficiency conditions are particularly significant in obstetrician-gynecologist practice, as they are most common among women of reproductive age with normal menstrual cycles, pregnant women, and women in the perimenopausal period. This article presents an analysis of data from the international literature on the role of iron deficiency and the possibilities for its correction in gynecological practice. Oral iron supplements are currently the first-line treatment for anemia. Today, the rationale for prescribing iron supplements to women with anemia is unquestionable, and the wide range of medications available requires physicians to carefully select the right one, taking into account their efficacy and safety. Research results show that iron protein succinylate is equally effective as iron salts in the treatment of iron deficiency anemia, while oral administration of iron protein succinylate does not result in hepcidin blockade or the development of gastrointestinal adverse effects. Prescribing oral iron supplements at optimal, low therapeutic doses helps minimize side effects and increases iron bioavailability, maintaining high efficacy and patient compliance.
About the authors
Inna A. Apolikhina
Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: efendievaz@yandex.ru
ORCID iD: 0000-0002-4581-6295
Dr. Sci. (Med.), Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor, Department of Obstetrics, Gynecology, Perinatology, and Reproductive Medicine, Institute of Postgraduate Education
Russian Federation, Moscow; MoscowZulfiya N. Efendieva
MOSITALMED International Medical Center
Author for correspondence.
Email: efendievaz@yandex.ru
ORCID iD: 0000-0002-2978-043X
Cand. Sci. (Med.), Obstetrician-Gynecologist
Russian Federation, MoscowVladimir N. Serov
Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology
Email: efendievaz@yandex.ru
Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, President of the Russian Society of Obstetricians and Gynecologists
Russian Federation, MoscowReferences
- Pantopoulos K. Oral iron supplementation: new formulations, old questions. Haematologica. 2024 Sep 1;109(9):2790-2801. https://doi.org/10.3324/haematol.2024.284967
- Виноградова М.А., Серебрийская Д.С. Железодефицитные состояния в гинекологии: эффективная коррекция периоперационной анемии. Медицинский совет. 2024;18(17):66-72. [Vinogradova M.A., Serebriyskaya D.S. Iron deficiency states in gynecology: effective correction of perioperative anemia. Medical Council. 2024;18(17):66-72. (In Russ.)]. https://doi.org/10.21518/ms2024-470
- Low M.S., Speedy J., Styles C.E., et al. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016 Apr 18;4(4):CD009747. https://doi.org/10.1002/14651858.CD009747.pub2
- Choi M.S., Seiger E.R., Murray-Kolb L.E. Cognitive Function in Peri- and Postmenopausal Women: Implications for Considering Iron Supplementation. Nutrients. 2025 May 23;17(11):1762. https://doi.org/10.3390/nu17111762
- Cappellini M.D., Santini V., Braxs C., Shander A. Iron metabolism and iron deficiency anemia in women. Fertil Steril. 2022 Oct;118(4):607-614. https://doi.org/10.1016/j.fertnstert.2022.08.014
- Nikzad Z., Iravani M., Abedi P., et al. The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women. PLoS One. 2018 Dec 6;13(12):e0208485. https://doi.org/10.1371/journal.pone.0208485
- Giuliano A.F.M., De Matteis C., Cantatore S., et al. Reduced serum iron levels are associated with metabolic dysfunction and sex-specific characteristics. Intern Emerg Med. 2026 Jan;21(1):129-139. https://doi.org/10.1007/s11739-025-04169-x
- Grewal M., Rehan M., Davalath D., et al. Iron Deficiency as an Underrecognized Cause of Dyspareunia and Vulvar Bleeding. Cureus. 2025 Oct 15;17(10):e94659. https://doi.org/10.7759/cureus.94659
- Vaucher P., Druais P.L., Waldvogel S., Favrat B. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 2012 Aug 7;184(11):1247-54. https://doi.org/10.1503/cmaj.110950
- Serati M., Espuña-Pons M., Mouton-Puglisi A., Padoa A. Iron deficiency and sexual dysfunction in women. Sex Med Rev. 2023 Sep 27;11(4):342-348. https://doi.org/10.1093/sxmrev/qead028
- Urman B., Boza A., Balaban B. Platelet-rich plasma another add-on treatment getting out of hand? How can clinicians preserve the best interest of their patients? Hum Reprod. 2019 Nov 1;34(11):2099-2103. https://doi.org/10.1093/humrep/dez190
- Parikh S., Bentz T., Crowley S., et al. Perioperative Blood Management. J Clin Med. 2025;14:3847. https://doi.org/10.3390/jcm14113847
- Guideline for the Management of Anaemia in the perioperative pathway 2022 Centre for Perioperative care (CPOC).
- National Institute for Health and Care Excellence (NICE). Blood transfusion. Quality standard. Published: 15 December 2016. nice.org.uk/guidance/qs138
- Muñoz M., Acheson A.G., Bisbe E., et al. An international consensus statement on the management of postoperative anaemia after major surgical procedures. Anaesthesia. 2018 Nov;73(11):1418-1431. https://doi.org/10.1111/anae.14358
- Lawton S. Skin changes associated with ageing. Br J Community Nurs. 2023 Oct 2;28(10):504-508. https://doi.org/10.12968/bjcn.2023.28.10.504
- Stangl S., Popp M., Reis S., et al. Reported outcomes in patients with iron deficiency or iron deficiency anemia undergoing major surgery: a systematic review of outcomes. Syst Rev. 2024;13:5. https://doi.org/10.1186/s13643-023-02431-x
- Wright J.A., Richards T., Srai S.K. The role of iron in the skin and cutaneous wound healing. Front Pharmacol. 2014 Jul 10;5:156. https://doi.org/10.3389/fphar.2014.00156
- Von Holle A., Ramamurthy S., Díaz Santana M.V., et al. Association Between Body Iron Status and Biological Aging. Nutrients. 2025 Apr 23;17(9):1409. https://doi.org/10.3390/nu17091409
- Wacka E., Nicikowski J., Jarmuzek P., Zembron-Lacny A. Anemia and Its Connections to Inflammation in Older Adults: A Review. J Clin Med. 2024 Apr 2;13(7):2049. https://doi.org/10.3390/jcm13072049
- Tear A.A., Tesno F.A., Shofiadeita H., et al. Association between anaemia and osteoporosis: a systematic review and meta-analysis. Ann Med. 2026 Dec;58(1):2610878. https://doi.org/10.1080/07853890.2025.2610878
- Ubom A.E., Begum F., Ramasauskaite D., et al. FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH). Int J Gynecol Obstet. 2025;171:993-1007. https://doi.org/10.1002/ijgo.70529
- Jessian L. Muñoz, Oluwatosin Goje. Anemia in Pregnancy. MSD Manual. Jul 2024 Modified Sept 2025.
- De Franceschi L., Iolascon A., Taher A., Cappellini M.D. Clinical management of iron deficiency anemia in adults: Systemic review on advances in diagnosis and treatment. Eur J Intern Med. 2017 Jul;42:16-23. https://doi.org/doi: 10.1016/j.ejim.2017.04.018
- Pavord S., et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020 Mar;188(6):819-830. https://doi.org/10.1111/bjh.16221
- Celis A.I., Relman D.A., Huang K.C. The impact of iron and heme availability on the healthy human gut microbiome in vivo and in vitro. Cell Chem Biol. 2023 Jan 19;30(1):110-126.e3. https://doi.org/10.1016/j.chembiol.2022.12.001
- Dentand A.L., Schubert M.G., Krayenbuehl P.A. Current iron therapy in the light of regulation, intestinal microbiome, and toxicity: are we prescribing too much iron? Crit Rev Clin Lab Sci. 2024 Nov;61(7):546-558. https://doi.org/10.1080/10408363.2024.2331477
- EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA). Scientific opinion on the tolerable upper intake level for iron. EFSA Journal 2024.
- Urso K., Leal Martínez-Bujanda J., del Prado, J.M. Iron Protein Succinylate in the Management of Iron Deficiency Anemia: A Comparative Study with Ferrous Sulphate at Low and High Therapeutic Doses. Nutrients 2021;13:968. https://doi.org/10.3390/nu13030968
- Izquierdo L. Efficacy and Tolerability of Oral Iron Protein Succinylate in the Treatment of Iron Deficiency Anemia in Adults with Gastrointestinal Diseases. International Journal of Gastroenterology. 2021;5(2):40-47. https://doi.org/10.11648/j.ijg.20210502.11
- Córdova A., Mielgo-Ayuso J., Fernandez-Lazaro C.I., et al. Effect of Iron Supplementation on the Modulation of Iron Metabolism, Muscle Damage Biomarkers and Cortisol in Professional Cyclists. Nutrients. 2019 Feb 27;11(3):500. https://doi.org/10.3390/nu11030500
- Martínez Francés, A., & Leal Martínez-Bujanda, J. Efficacy and tolerability of oral iron protein succinylate: a systematic review of three decades of research. Curr Med Res Opin. 2020;36(4):613–623. https://doi.org/10.1080/03007995.2020.1716702
- Михайлова О.И., Мирзабекова Д.Д., Тютюнник В.Л., Кан Н.Е. Терапия железодефицитной анемии в послеродовом периоде. Фармакология & Фармакотерапия. 2022;(3):60-3. [Mikhailova O.I., Mirzabekova D.D., Tyutyunnik V.L., Kan N.E. Treatment of iron deficiency anemia in the postpartum period. Pharmacology & Pharmacotherapy. 2022;(3):60-3. (In Russ.)]. https://dx.doi.org/10.46393/27132129_2022_3_60
Supplementary files
