Low iron and periods - what you need to know.

July 14, 2020

 Words by Dr. Pavitra Nanayakkara


In the field of Obstetrics and Gynaecology, we see many patients with iron deficiency anaemia. It’s a common cause of tiredness and fatigue that is easy to diagnose and treat. Some patients normalise their symptoms and don’t always seek help; hopefully this article will help demystify the condition and encourage people to be tested.


What’s the deal?

Anaemia is a medical condition that occurs when you don’t have enough healthy red blood cells to meet the needs of your body.  There are many types of anaemia; iron deficiency anaemia is one of the most common, which happens where there is not enough iron in your blood.  We need iron to make something called haemoglobin, which helps transport oxygen around your body.  Without enough haemoglobin, you can end up having low energy levels and feeling pretty tired.

Why does it happen?

There are two main reasons why iron deficiency happens – either you’re not getting enough iron in, or you are losing it.  We get iron from our diet, however there are some medical conditions that can stop us absorbing it properly even if there is enough in the food we eat. The most common reason for losing iron is bleeding, such as heavy bleeding during our periods or bleeding from your gut. If you are a blood donor, then you may need to stop until your iron levels are back to normal.

Where does my period fit in?

Heavy bleeding related to periods is a common cause of iron deficiency anaemia.  Periods are a regular source of blood loss, and if they are heavy, you may lose more iron than what you are able to consume through your diet.  If you think your periods might be heavy, it is important that you see doctor for more treatment options.

How do I know if I’m iron deficient?

Iron deficiency can be asymptomatic, meaning you won’t feel any difference when your iron levels are low. If iron deficiency leads to anaemia, meaning that you are not just iron deficient but that your blood level (haemoglobin) is also low, symptoms are more likely to develop. Some people feel more tired or notice changes in their mood, but these are non-specific and can be due to many things. Some unusual symptoms can also occur, like tongue pain or even cravings for ice or dirt!

To know for sure, your doctor can run some basic blood tests for your blood and iron levels.  Since there are other causes for tiredness, your doctor may also run some other blood tests to check on a few other causes too.

What can I do about it?

Prevention is always better than cure, and there are several ways to improve your iron levels without medications. Foods that contain plenty of iron include red meat, eggs, shellfish, chickpeas, beans, legumes, green leafy vegetables, and iron-fortified cereals, as well as pumpkin and sesame seeds. Food with Vitamin C also help with absorbing iron, so eating citrus fruits, broccoli, grapefruit, kiwifruit or strawberries can also be helpful.

If diet alone doesn’t get your iron levels up, your doctor may recommend iron tablets or an injection of iron. It is also important to treat whatever is causing the iron deficiency anaemia, so sometimes your doctor will offer you tests and treatments for heavy periods too.




About the writer

Dr Pav Nanayakkara (MBBS/BMedSc (Hons) MRMed (Hons)) is a Fellow in Minimally Invasive Gynaecological Surgery.  She grew up in a regional area and chose to specialise in gynaecology with a vision to help empower young girls and women to manage their health without embarrassment or fear. During her training, she was inspired by minimally invasive strategies (keyhole and robotic surgery) to help treat gynaecological issues, allowing for less pain, quicker recovery/return to work and better cosmetic effect for patients. Her long-term vision is to improve access to innovative techniques in laparoscopic and robotic surgery in the rural setting.  

After her medical degree, she completed an honours year in research as a scholar of the RANZCOG Research Foundation. She undertook her Obstetrics and Gynaecology training at The Royal Women’s Hospital, obtaining her DRANZCOG qualification in 2011 and completing specialist examinations in 2015 and 2016. She was awarded a Masters of Reproductive Medicine with Excellence in 2019.

Pav is passionate about Women’s Health and is director of “The Birth Bundle Project”, an initiative providing birthing kits to hospitals in developing countries.  Pav has an enthusiasm for teaching. In 2018, she was the recipient of the Women’s Health “Inspire Me” Mentor of the Year award from Monash University “in recognition of her dedication as a mentor, outstanding willingness to share knowledge and for inspiring the next generation of Obstetricians and Gynaecologists”.  

In her spare time, Pav loves cooking, travelling, hiking and going on adventures with her young family.

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