Anemia During Period

Overview

Iron deficiency is the most common cause of anaemia, a condition that can occur both suddenly and over time, and leave you feeling weak and fatigued.1 Anaemia takes place when the body has a shortage of red blood cells. Since blood loss is the most common cause, menstruating women are particularly susceptible to anaemia. This is because after blood loss there is inevitably iron loss, if your nutrition isn’t adequate, it will not restore the loss leading to iron deficiency anaemia.

The extent of blood loss during menstruation can be contingent on hormonal birth control, weight, diet, or conditions such as endometriosis. Furthermore, heavy bleeding during your period can be initiated by various factors such as uterine fibroids, medications, bleeding disorders, or polyps.1

As anaemia appears due to a lack of healthy red blood cells, the body does not carry sufficient oxygen to the tissues and organs. This leads to feeling weak, cold, and tired.1 There are several types of anaemia, the most common being iron-deficiency anaemia. You can start to alleviate symptoms of this form of anaemia by increasing iron intake in your diet.

What is anaemia?

Anaemia is a medical condition where the body does not have sufficient red blood cells (healthy). These red blood cells are responsible for providing oxygen to the tissues in the body. There are different types of anaemia, and all of them cause a decrease in the number of healthy red blood cells. For example, there is anaemia due to folate deficiency as well as vitamin B12 deficiency.3

Anaemia affects greater than two billion people worldwide, this is more than 30% of the total population.3 It is particularly widespread in territories with limited resources; however, it also affects numerous people in developed countries.

It is important to note anyone can develop anaemia, though the subsequent groups of people have a greater risk:

  • Those prescribed blood thinners; Drugs such as aspirin, dabigatran (Pradaxa), and rivaroxaban (Xarelto)3
  • Women: Lose of blood during childbirth and periods can lead to anaemia, specifically if you have uterine fibroids or heavy periods
  • Children from ages 1-2: Their bodies require more iron through growth spurts
  • People over the age of 65: They are more likely to have a reduced amount of iron in their diets and particular chronic illnesses such as high blood pressure

Signs of anemia

A patient with anaemia might describe feeling a reduced ability to concentrate, weakness, and exhaustion, these symptoms can start slowly or quickly.

Sometimes anaemia can progress slowly, this allows the body to adjust to changes, so symptoms will not be seen until the anaemia is severe. These symptoms include cold feet/hands, rapid heartbeat, feeling tired, shortness of breath, difficulty concentrating, dizziness, nausea, and muscle weakness.4 When anaemia develops quickly it has more severe symptoms, including, confusion, feeling faint, sweating, and heightened thirst. There can also be further symptoms relying on the fundamental cause of the condition. 

Anemia and heavy periods

The length of every woman’s period is unique. Some women have their period for two to three days, whilst others have theirs last a week. Though the length of your menstrual cycle can differ, some signs should not be overlooked.

Heavy menstrual bleeding is also recognized as menorrhagia, this condition can harshly affect wellbeing and quality of life.5 These are some indications that your period is too heavy or long:

  • Having to change tampons or pads through the night
  • Passing blood clots bigger than a coin
  • Completely immersed tampons or pads within an hour
  • Blood loss from periods lasting longer than a week

You should note that you cannot lose enough blood during a normal menstrual cycle to experience any negative side effects, it is the significant/substantial blood loss that leads to anaemia.5 

Advice for coping with anemia during a period

The symptoms of anaemia and heavy menstrual bleeding can be decreased in many ways, the best way includes eating foods rich in iron to maintain haemoglobin levels at the standard level. The greatest food sources of dietary iron include:

  • fish
  • poultry
  • grains
  • dairy
  • beans
  • eggs
  • red meat
  • tofu
  • leafy greens

Many nutritionists advocate for the reduction or complete avoidance of caffeine, especially after eating a meal. This is because caffeine can reduce iron absorption.6 On the other hand, vitain C supplement increases iron absorption by the digestive system. Anaemic patients are advised to drink fruit juices such as orange juice after their meals.6

A doctor can prescribe you oral iron supplements if you have anaemia or suffer from heavy bleeding during menstruation. It is important to note that it is dangerous to self-medicate with iron supplements, this is because when used unsuitably, they can cause problems such as liver damage and constipation.6

Many women use period trackers or calendars to understand and govern their cycles, this allows for spotting irregular patterns and symptoms. Keeping a record of this information is very useful during medical consultations.   

When to see a doctor

It may be difficult for you to know when to see a doctor as blood loss during periods vary from woman to woman, but normal blood loss during your period should not be more than a few millilitres. Heavy menstrual bleeding is described as a loss of more than 80 ml of blood for the duration of the entire menstruation. It’s difficult to calculate accurately how much blood you’ve lost during your period, so here are ways to confirm if your period blood loss is excessive:

  • Bleeding through bedding or clothes (when you’re using protection)
  • Needing to change your tampon or pad less than every 2 hours
  • Requiring double protection (both tampons and pads)
  • larger blood clots
  • extreme bleeding that disturbs your normal routine

It is important to discuss heavy periods with your doctor as it can cause many unpleasant symptoms such as anaemia. The first step is listening to your body and making a note of symptoms like exhaustion and excessive bleeding. It is possible to manage both anaemia and bleeding disorders with routine, lifestyle changes and treatment.6

Summary

Iron deficiency anaemia as well as other types of anaemia can deeply affect the well-being and quality of life of women. This is due to bleeding disorders associated with menstruation and conditions such as abnormal uterine bleeding which can exacerbate symptoms of anaemia and develop severity. These symptoms can range from fatigue to confusion and difficulty concentrating. Lifestyle changes such as proactively selecting iron-rich foods and documenting your menstrual flow can help control and manage your anaemia. Patients are advised to visit the doctor where they can receive further support such as regular blood tests and oral iron supplements.  

References

  1. Wilke M. Your period and anaemia – what you should know [Internet]. Health24. [cited 2022 Sep 19]. Available from: https://www.news24.com/health24/medical/anaemia/news/your-period-and-anaemia-what-you-should-know-20181203
  2. Untitled [Internet]. [cited 2022 Sep 19]. Available from: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/anemia
  3. Anemia: symptoms, types, causes, risks, treatment & management [Internet]. Cleveland Clinic. [cited 2022 Sep 19]. Available from: https://my.clevelandclinic.org/health/diseases/3929-anemia
  4. Anemia. In: Wikipedia [Internet]. 2022 [cited 2022 Sep 19]. Available from: https://en.wikipedia.org/w/index.php?title=Anemia&oldid=1108413810
  5. Can heavy periods cause anemia? : women’s health specialists: ob/gyns [Internet]. [cited 2022 Sep 19]. Available from: https://www.pro-lifeobgyn.com/blog/can-heavy-periods-cause-anemia
  6. Is your anemia due to heavy periods? [Internet]. Flo.health - #1 mobile product for women’s health. [cited 2022 Sep 19]. Available from: https://flo.health/menstrual-cycle/health/symptoms-and-diseases/iron-deficiency-anemia-and-periods
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Iqra Khalif

Pharmaceutical Science, University of Hertfordshire

Iqra Khalif is a pharmaceutical scientist with deep roots in research and development. She has a leadership qualification in global health and is interested in strategising for innovation in the life sciences.
She currently works in data analytics and management for a health-tech startup.

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