Menstrual fatigue and iron loss: why women shouldn’t just ‘put up with it’

Irish iron supplement brand Active Iron, argues that the connection between low iron, menstrual fatigue and heavier periods can sometimes be overlooked by community health professionals.

Heavier periods are ‘regularly’ or ‘occasionally’ experienced by over two-thirds of the 1,944 women in Ireland and the United Kingdom who took part in a survey carried out by Active Iron¹.

While nutritional deficiencies and inadequate iron status are easily addressed, women are often not made aware that managing iron intake with iron supplements maybe be a solution to debilitating period-related fatigue.

The Facts. Period!

Problem periods are one of the most common women’s health issues, affecting up to two-thirds of reproductive-aged women globally¹. Menstrual bleeding is already the most common global cause of low iron levels². However, some studies show women with heavier periods lose five to six times more iron per cycle that those with regular period blood-loss³.

While the majority of survey respondents reported at least one menstrual symptom, the severity of every symptom was greater in those with heavier periods. This leads to the conclusion that iron levels are a significant factor to evaluate in women’s menstrual health.

Menstrual Symptoms most commonly reported by the participants in the survey were stomach cramps/pain (76%), tiredness/fatigue (65%), mood problems (57%), backache (51%) and breast tenderness (43%).

Dr Monica Peres, GP and Active Iron Ambassador maintains there is no surprise in the menstrual symptoms presented, or in the fact that women with heavier periods experience fatigue as part of their period.

"Someone with inadequate iron levels will experience decreased energy levels. So, of course, women who regularly have heavier periods can experience tiredness and fatigue.

“What I found astonishing is that women just seem to ‘put up’ with extreme tiredness and discomfort, but health professionals do have solutions available to help support women’s needs”.

More Comprehensive Approach

While period pain is commonly experienced by those suffering with heavier periods, fewer (4 in 10) reported having to ‘put up with it’. This likely reflects the widespread availability of over-the-counter anti-inflammatories and pain relief that women with periods and community healthcare providers use to manage menstrual pain.

In contrast, fatigue gets less attention. The belief is that some women may not make the connection between menstrual fatigue, iron and blood loss from periods.

But healthcare professionals can advocate for a more comprehensive approach to women’s menstrual health.

6 in 10 of the women with regular heavier periods, and half of those with occasional heavier periods experience tiredness and fatigue; considerably higher percentages than the 40% without heavier periods.

According to Jess Redden, Pharmacist and Active Iron Ambassador: It’s concerning that among those seeking medical help, fewer than half subsequently received a formal diagnosis of heavier periods. Advice can be limited to pain relief and hormonal contraception. As pharmacists we are trained to deal with all sorts of pain issues and are happy to help with not only medication, but also supplementation suggestions (when there is an identified requirement for iron) from clinically proven brands such as Active Iron.”

Additionally, these women tended to delay seeking help, often waiting an average of 1-3 years before reaching out.

Heavier periods can have a significant impact on health-related quality of life and overall well-being. And yet, many assume that little can be done about the fatigue associated with menstruation, and that ‘putting up with it’ is the norm.

Dr Peres maintains there is a recognised lack of research into problem periods and menstrual health in general.

‘There are a number of explanations for this including a sex/gender bias in medical research, the perception that few treatments are available, and cultural barriers to openly discussing menstruation’.

Closing this research gap is essential for advancing medical understanding, improving treatment options, and ensuring menstrual health receives the scientific attention it merits. Increased investigation into this area will help challenge existing biases and lead to more informed, evidence-based care.

As part of their latest campaign, Active Iron is urging women not to accept menstrual fatigue and to take charge of their health by learning more about their menstrual cycle and finding support at activeiron.com.

¹Active Iron Survey 2021.

²Fernandez-Jimenez et al. 2020. Women’s Health Reports.

³Napolitano M, Dolce A, Celenza G, Grandone E, Perilli MG, Siragusa S, et al. Iron dependent erythropoiesis in women with excessive menstrual blood losses and women with normal menses. Annals of Hematology. 2013 Sep 19;93(4):557–63.13.