A 40-year-old female presents with fatigue, pallor, and heavy menstrual bleeding. Her blood test shows a hemoglobin of 7 g/dL, MCV of 68 fL, and ferritin of 6 ng/mL. What could be the potential causes, and what are the next steps?
This patient is showing signs of iron deficiency anemia, likely caused by menstrual blood loss, as evidenced by her microcytic anemia and low ferritin. The next step is to manage her anemia, possibly with iron supplementation. It would also be prudent to discuss menstrual management strategies, and consider referral to gynecology if her periods remain unmanageable.