Should pre-menopausal women be concerned about anemia?

These are some of the symptoms

(Lily illustration)

Adapted from a story by Erin Blakemore for The Washington Post.

Menstruation and pregnancy are the main causes of iron deficiency in women.

“Iron is generally fairly difficult to get rid of except by losing blood or by having babies,” says Nancy Berliner, chief of hematology at Brigham and Women’s Hospital and deputy editor of Blood, the medical journal of the American Society of Hematology.

If it’s not corrected, iron deficiency — low stores of iron — can lead to iron-deficiency anemia, in which red blood cells don’t make enough hemoglobin, the protein that carries oxygen through the body.

It’s pretty concerning for women.


In addition to fatigue and neurological issues, the anemia can cause dizziness, a rapid heartbeat, less strength and cardiac complications.

Although most of the 5,200 Americans who die of anemia annually are women age 65 and older, iron-deficiency anemia in younger women can cause pregnancy complications and serious health problems including persistent fatigue and even heart failure.

Who’s at risk?

Pregnant women and pre-menopausal women who still get their periods are at the highest risk of iron deficiency and iron-deficiency anemia, both of which can cause such problems as fatigue and severe neurological damage.

Iron-deficiency in pregnancy women

The National Heart, Lung, and Blood Institute says that 1 in 5 women of childbearing age have iron-deficiency anemia, and about half of all pregnant women develop the condition, at least temporarily.

“Babies are excellent at siphoning iron away from their moms,” Berliner says. During pregnancy, women’s bodies create more blood not just for themselves but also for their babies, which can deplete their own iron stores. But regular menstruation and heavy periods — especially the heavier flows experienced by pre-menopausal women — also take their toll.


Correcting an iron deficiency

  • Sometimes, eating more of such foods as lean meat, chicken, seafood, fortified cereal and bread, nuts and beans can correct a deficiency.
  • Iron supplements can be hard to stomach — literally — because they can cause an upset stomach or constipation. Doctors recommend proceeding with caution.
  • In cases where women need supplementation but don’t tolerate iron pills, physicians can administer intravenous iron.
“If people are aware” of warning signs and get tested for iron deficiency, Berliner says, “they can prevent the development of severe symptoms.”
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