What is the initial treatment for a 19-year-old female with iron deficiency anemia from heavy menstrual bleeding?

The initial treatment for iron deficiency anemia, particularly in young females with a history of heavy menstrual bleeding, typically involves oral iron supplementation, with ferrous sulfate being the most commonly prescribed. This approach is favored because oral ferrous sulfate is effective in replenishing iron stores and improving hemoglobin levels over time. It is also more convenient, less invasive, and less expensive compared to other forms of iron supplementation, such as intravenous iron.

For a 19-year-old female, it is essential to manage the underlying cause of her anemia, which in this case is the heavy menstrual bleeding. However, the immediate need is to restore her iron levels to alleviate the symptoms of anemia and prevent further complications. Oral ferrous sulfate provides a readily available and effective option for this purpose.

While dietary adjustments can be beneficial in overall nutrition and long-term management, they usually won't provide sufficient iron for a patient already diagnosed with iron deficiency anemia. A bone marrow biopsy is typically reserved for more complex cases of anemia where the cause is unclear, and intravenous iron is generally considered if oral iron is ineffective or if there’s a need for rapid replenishment, which is not the first step in most straightforward cases of iron deficiency due to menstrual bleeding.