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Hematology

MCV in women: small or large red blood cells and the role of menstrual blood loss

According to Thuisarts, the body needs iron, vitamin B12 and folate to make haemoglobin, the protein in red blood cells that carries oxygen. According to the NVKC, the average size of the red blood cells, the MCV, gives information about the cause of anaemia.

According to the NVKC, a low MCV can point to anaemia from iron deficiency, a high MCV to anaemia from a shortage of vitamin B12 or folate. Only a blood test shows how large the cells are.

Certe uses an MCV of 80 to 100 femtolitres (fL) for women older than 18, and Unilabs 80 to 100 fl for women older than 15.

Doctor's Assessment Included

MCV is the average size of the red blood cells. According to the NVKC, a high MCV can point to a shortage of vitamin B12 or folate, a low MCV to iron deficiency.

  • Star-SHL, Unilabs, Certe and Diagnostiek voor U all four use an MCV of 80 to 100 fl for adults.
  • A US review article (American Family Physician, 2009) names alcoholism, a shortage of vitamin B12 or folate and medicines as the most common causes of an MCV above 100 fl.
  • According to a US review article (American Family Physician, 2010), anaemia from iron deficiency and thalassaemia trait are the most common causes of an MCV below 80 fl in adults.

Reference Ranges

Female
fl
Low 80 Normal 100 High

Source: NVKC — Nederlandse Vereniging voor Klinische Chemie en Laboratoriumgeneeskunde Reference population: Healthy adults (NVKC)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

MCV (Mean Corpuscular Volume): what Dutch laboratories use

Reference ranges by group, in fl
Star-shl · Everyone · 19 years and older 80–100 fl
80 100
Unilabs · Female · 15 years and older 80–100 fl
80 100
Certe · Female · 18 years and older 80–100 fL
80 100
Diagnostiek voor U · Female · 16 years and older 80–100 fL
80 100
75 105 fl

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

MCV (Mean Corpuscular Volume): what this test measures

The MCV test measures in femtolitres how large the red blood cells are on average. Certe uses 80 to 100 fL for women older than 18, and Diagnostiek voor U gives women aged 12 to 15 their own limit of 79 to 95 fL.

MCV (Mean Corpuscular Volume): why this value matters

According to a US review article (American Family Physician, 2010), in menstruating women a low MCV from iron deficiency most commonly has menstrual blood loss as its source. According to Thuisarts, anaemia usually comes from too little iron, often through blood loss, for example with heavy periods or a stomach disease.

MCV (Mean Corpuscular Volume): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

MCV (Mean Corpuscular Volume): when is testing worthwhile?

According to the NVKC, a doctor can request the MCV when looking for the cause of anaemia, and it usually comes as one of the results of the complete blood count.

MCV (Mean Corpuscular Volume): symptoms of a high or low value

Low Levels

According to a US review article (American Family Physician, 2010), in menstruating women a low MCV has these causes, in descending order of how often they occur: anaemia from iron deficiency, thalassaemia trait, pregnancy, anaemia of chronic disease and sideroblastic anaemia, a form of anaemia. According to the NVKC, thalassaemia is an abnormality of the haemoglobin protein in the red blood cells.

High Levels

A high MCV, according to the NVKC, can be a sign of anaemia caused by a lack of vitamin B12 or folate. According to a US review article (American Family Physician, 2009), anaemia with red blood cells that are too large is much less common during pregnancy, because pregnant women routinely take folic acid in prenatal vitamins.

MCV (Mean Corpuscular Volume): causes of a low or high value

What lowers the value

  • Iron deficiency

    A low MCV can point to anaemia from iron deficiency.

  • Thalassaemia

    In thalassaemia, an abnormality of the haemoglobin protein in the red blood cells, the MCV is too low.

  • Anaemia of chronic disease

    A US review article names anaemia of chronic disease as another cause of red blood cells that are too small.

What raises the value

  • Vitamin B12 or folate shortage

    A high MCV can point to anaemia from a shortage of vitamin B12 or folate.

  • Alcoholism

    A US review article names alcoholism as one of the most common causes of an MCV above 100 fl; with chronic alcohol use the MCV generally stays below 110 fl.

  • Medicines

    According to a US review article, medicines including anti-epileptic drugs, methotrexate and metformin may enlarge the red blood cells.

  • Underactive thyroid or liver disease

    According to a US review article, an underactive thyroid and liver disease are associated with a less marked rise in the MCV.

  • Blood loss or breakdown of red blood cells

    After blood loss or breakdown of red blood cells the MCV can rise, because the bone marrow releases young red blood cells that are slightly larger than average.

MCV (Mean Corpuscular Volume): lifestyle and this value

Discuss an abnormal MCV with your GP. According to Thuisarts, someone with anaemia from too little iron is given iron tablets, and Thuisarts recommends eating an orange or a kiwi with the iron tablet.

MCV (Mean Corpuscular Volume): frequently asked questions

Is the normal MCV range different for women than for men?

For adults the normal MCV range is the same for women and men: Certe, Unilabs and Diagnostiek voor U use 80 to 100 femtolitres for both. At Diagnostiek voor U the limit does differ at ages 12 to 15: 79 to 95 fL for women and 78 to 92 fL for men.

MCV (Mean Corpuscular Volume): sources

  1. Nederlandse Vereniging voor Klinische Chemie en Laboratoriumgeneeskunde. MCV. "Bij gezonde volwassenen ligt de MCV-waarde ongeveer tussen 80 en 100 femtoliter." Tevens: "Deze referentiewaarden kunnen per laboratorium iets variëren." De bron maakt geen onderscheid tussen mannen en vrouwen. Geraadpleegd 13 augustus 2026. (retrieved 2026) allesovertesten.nl
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NVKC, Alles over testen: MCV, allesovertesten.nl, geraadpleegd 2026-10-15 (retrieved 2026) allesovertesten.nl
  7. Van Vranken M. Evaluation of Microcytosis. Am Fam Physician. 2010;82(9):1117-1122 (retrieved 2026) aafp.org
  8. Kaferle J, Strzoda CE. Evaluation of Macrocytosis. Am Fam Physician. 2009;79(3):203-208 (retrieved 2026) aafp.org

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