Iron Deficiency in Perimenopause: The Hidden Energy Drain

Following on from my last blog on heavy periods in perimenopause, another hidden energy drain can be iron deficiency.

This is an important topic because firstly iron deficiency is common, it can cause a wide variety of symptoms (sometimes it isn’t perimenopause, it’s iron deficiency!), and lastly, unfortunately women often struggle to get diagnosed and therefore don’t get treated properly.

To advocate for yourself, you need to know the symptoms of iron deficiency and the causes.

What is Iron deficiency?

Iron deficiency is the most common nutritional deficiency. Many people know that low iron can lead to anemia, a condition where the body isn’t making enough red blood cells. Iron is a vital mineral that helps your body produce hemoglobin, a protein in red blood cells that carries oxygen from your lungs to the rest of your body.

Iron is needed for many other processes within our bodies, because every cell requires iron to function properly. For example, iron is needed for DNA synthesis and repair, lipid (fat) metabolism, and for mitochondria (our bodies energy source)- which is why when iron is low, your energy levels can feel non-existent.

Given iron is essential for oxygen transport in the blood, energy production, and cognitive function. During perimenopause, menstrual cycles can become heavier or more erratic, increasing the risk of iron loss. Combine that with decreased nutrient absorption and dietary changes, and it’s no surprise many women feel inexplicably fatigued, foggy, or weak.

The problem? These symptoms often mimic typical perimenopausal symptoms and often go undiagnosed.

While iron deficiency anemia is an important medical condition, women can be iron deficient without having anemia.

Here’s a list of symptoms associated with iron deficiency:

• Absent mindedness

• Decreased cognitive function

• Decreased exercise tolerance

• Depression

• Dry skin

• Fatigue

• Headache

• Hair loss

• Joint pain

• Memory problems

• Muscle pain

• Palpitations

• Restless leg syndrome

• Sleep disturbances

• Weakness

• Weight gain

How many of these are also a symptom of perimenopause and menopause?

If you have these symptoms, before you or your medical team blames perimenopause, you need to know your iron status. And of course, it can be both, or something else. But is is good to be able to rule our iron deficiency.

What causes iron deficiency?

It’s important to understand the cause of iron deficiency, so it can be treated properly. Some causes can be due to inadequate iron in the diet, some people don’t absorb iron from food as well as others because of bowel conditions, such as celiac disease and inflammatory bowel disease. Additionally, blood loss is also a cause of iron deficiency, because the body has to make up for the extra red blood cells being lost, such as menstruation.

Testing for iron deficiency

If you are experiencing any of the symptoms above, you may want to talk to your GP about getting tested. Thankfully a simple blood test can confirm iron levels.

The good news: iron deficiency is treatable.

A diet rich in iron (think red meat, lentils, spinach) and, when necessary, supplements can make a dramatic difference.

Tip: Add vitamin C foods to your iron rich foods to increase absorption (think a squirt of lemon/lime juice, berries, kiwifruit, broccoli, potatoes).

During perimenopause, it's easy to dismiss symptoms as “just hormones.” But sometimes, it’s your body quietly asking for more iron. Listen closely—it might be the key to feeling like yourself again.