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Heghine Khachatryan: Low Ferritin in Endometriosis Is Not a Minor Finding
Heghine Khachatryan/LinkedIn
Apr 14, 2026, 12:08

Heghine Khachatryan: Low Ferritin in Endometriosis Is Not a Minor Finding

Heghine Khachatryan, Editor-in-Chief at Hemostasis Today, shared a post by Haemophilia Journal on LinkedIn:

“Endometriosis is not only a pain disorder.

It should increasingly be recognized as a systemic clinical condition, associated not only with chronic pelvic pain, dysmenorrhea, and infertility, but also with fatigue, significant impairment in quality of life, heavy menstrual bleeding, and iron deficiency.

Recent international evidence suggests that women with endometriosis are at increased risk of iron deficiency, and in many cases, low ferritin may be present even before overt anemia develops.

This requires a shift in our clinical thinking.

When a patient presents with:

  • heavy menstrual bleeding
  • pronounced fatigue
  • pelvic pain
  • subfertility
  • and ‘borderline normal’ hemoglobin

we should not limit management to symptomatic pain control alone.

A comprehensive evaluation should include:

  • ferritin levels
  • complete blood count indices
  • assessment of iron deficiency
  • evaluation for abnormal uterine bleeding / adenomyosis overlap
  • and the overall inflammatory and functional burden of disease

Modern management of endometriosis is multidimensional:

  • early clinical suspicion
  • targeted imaging
  • individualized management of pain and bleeding
  • timely identification and correction of iron deficiency
  • and, when appropriate, consideration of newer therapeutic options, including oral GnRH antagonists in selected patients

The key message is clear:

Low ferritin in a woman with endometriosis is not a minor laboratory finding.

It may represent a clinically meaningful indicator of:

  • ongoing blood loss
  • disease burden
  • and unrecognized functional compromise

Contemporary endometriosis care must go beyond lesion detection and focus on: iron status, bleeding burden, and the full impact on a woman’s daily life.”

Heghine Khachatryan

Stay updated on all scientific advances in the field of fertility with Fertility News.

abnormal uterine bleeding adenomyosis anemia chronic pelvic pain Dysmenorrhea endometriosis fatigue ferritin levels Heavy Menstrual Bleeding Heghine Khachatryan hemoglobin infertility inflammatory Iron Deficiency low ferritin oral GnRH antagonists pronounced fatigue subfertility
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