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First a little brush up on physiology:
Hemoglobin is present in our red blood cells (RBCs). The body maintains the RBC count by erthropoiesis( secreted from kidney)which stimulates the bone marrow which produces later forms RBCs. Anemia is a condition that develops when there is less amount of hemoglobin in the body.
Now the reasons for men having higher hemoglobin are:
All other factors (age, body mass , etc.) being equal, the levels are lower in healthy females not because of menstrual blood flow (20-30 ml).
It is the estrogens in females which have an inhibitory effect on secretion of erythropoietin (EP) which is main stimulant of red cell production.
Also, the androgens (mainly testosterone ) have a stimulatory effect on EP secretion.
Both these factors tend to keep the red cell count higher in males.
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