Anaemia in Women: Signs and Solutions

Feeling tired all the time is so common in women that it is easy to write off, but persistent exhaustion, pale skin and breathlessness can all point to anaemia. Anaemia means your blood does not carry enough oxygen around your body, most often because of low iron, and women are disproportionately affected. Heavy periods, pregnancy and diet all play a part. Here is how to spot it and what to do.

Why anaemia is so common in women

The most common cause is iron-deficiency anaemia, and women lose iron every month through periods. When loss is heavier than usual, stores drain faster than food can refill them. Pregnancy adds demand, because the growing baby needs iron too. Other causes include a low-iron diet, poor absorption due to conditions such as coeliac disease, and blood loss from the gut, which is why it is worth checking rather than assuming.

The signs to take seriously

• Persistent tiredness and weakness even after a decent night's sleep
• Pale skin, pale inner eyelids and pale gums
• Shortness of breath on stairs or gentle activity
• Dizziness, light-headedness or feeling faint
• Cold hands and feet, brittle nails, and a craving for unusual things such as ice

Some of these, like pica, sound odd but are well recognised in iron deficiency. If several of these sound familiar, a simple blood test will settle it.

Not all anaemia is the same

Iron deficiency is by far the most common, but not the only type. Vitamin B12 and folate deficiency cause a different anaemia with its own symptoms, including tingling in the hands and feet, and some women carry thalassaemia trait, which can look like mild anaemia on a test. This is why you should not simply buy iron supplements and hope; a GP can identify the type.

Boosting iron through food

Iron-rich foods include red meat, chicken, fish, beans, lentils, chickpeas, tofu, dark leafy greens, dried fruit and fortified cereals. Vitamin C unlocks plant iron, while tannins in tea and coffee block it, so a glass of orange juice with meals helps and tea is best left until an hour afterwards.

When to see a GP and get tested

See a GP if tiredness has been going on for a few weeks, if you are pale and breathless, or if your periods are very heavy. A full blood count and ferritin test will show whether you are anaemic and whether your iron stores are low. If you have been bleeding heavily, the period pain and irregular periods guides are worth reading alongside this one.

How anaemia is treated

For iron-deficiency anaemia, the standard treatment is an iron supplement prescribed based on your blood results, usually for three months, followed by a recheck. Take tablets with food, and note that they can turn stools dark, which is harmless. If they upset your stomach, tell your GP, because gentler formulations exist. Once levels recover, the underlying cause still needs addressing or the anaemia will return. Always check with a pharmacist or GP before taking supplements.

Anaemia in pregnancy and beyond

Iron needs rise sharply in pregnancy, which is why it is checked at your booking appointment and again later. The pregnancy vitamins guide covers what to take before and during pregnancy. After the menopause, heavy periods stop being the cause, so anaemia in older women needs investigating for gut blood loss. Whatever your age, feeling constantly drained is worth a ten-minute appointment.

Anaemia is common, easily diagnosed and very treatable, and recovery is often dramatic. If the word tired does not begin to cover how you feel, ask for the blood test rather than pushing on.