Project Summary

Reducing menstrual blood loss in adolescent girls living in low- and middle-income countries (LMIC) may be key to meet their iron requirements for first pregnancy and to prevent severe, life-threatening anemia during pregnancy or after childbirth; it can also improve their psychosocial health, education, equity, empowerment, and rights. Iron supplementation has several limitations including limited efficacy, low adherence, and potential risk of infectious diseases. We will assess the effect of supplementation with iron-containing micronutrients and ibuprofen on menstrual blood volume loss, menstrual iron loss, iron status, menstrual duration, menstrual cycle length, and self-reported indicators of menstrual blood loss and quality of life in menstruating Malawian girls aged 15-20 years in Zomba district using 2×2 factorial, double-blind, placebo-controlled trial design. Participating schoolgirls (n=450) will be randomly allocated to daily oral supplementation with iron-containing micronutrients or its placebo, and daily oral ibuprofen (1,200 mg/day in 4 doses for 4 days, starting on the first day of menstruation during each menstrual cycle) or its placebo, for a duration of 6 menstrual cycles or 8 months, whichever comes last. Menstrual blood loss will be assessed by alkaline hematin method during a run-in period for two menstrual cycles before randomization and throughout the intervention period, along with other outcome variables.

Funding

Project Partners

• Training and Research Unit of Excellence
• Wageningen University
• ETH Zurich
• Sight and Life

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