Perimenopause, Hormones and Iron Deficiency Anemia Risk

The Link Between Perimenopause and Iron Deficiency Anemia

Many women begin experiencing irregular periods and unpleasant symptoms as they enter perimenopause in their 40s and 50s. One of the most common yet overlooked issues is iron deficiency anemia.

What Happens During Perimenopause?

Perimenopause refers to the transitional stage leading up to menopause when reproductive hormones like estrogen and progesterone decline unevenly. This hormonal rollercoaster causes changes like:

• Period irregularity
• Hot flashes and night sweats
• Vaginal dryness
• Mood swings and irritability
• Trouble sleeping

These fluctuating hormones also influence iron levels and can contribute to exhaustion and anemia.

Heavy Periods and Iron Loss

Many women lose significant quantities of blood during perimenopause as menstrual flow and duration shifts sporadically. The average period sheds around 2-3 tablespoons of blood.

However, changing reproductive hormones often trigger heavier flow exceeding 5 tablespoons per cycle. Losing too much blood interferes with iron replenishment and raises anemia risk.

What Is Iron Deficiency Anemia?

Importance of Iron Levels

Iron plays vital roles in oxygen transport and energy production. As a component of hemoglobin within red blood cells, iron grasps oxygen molecules in the lungs.

Red blood cells distribute oxygen-rich hemoglobin throughout the body via blood circulation. Organs then utilize iron-containing oxygen to fuel cellular activities.

Anemia Causes and Symptoms

If the body lacks sufficient iron stores to produce adequate numbers of healthy red blood cells, anemia can develop. This causes unpleasant symptoms like:

• Fatigue, weakness and low energy
• Shortness of breath
• Rapid heartbeat
• Pale skin, nails and gums
• Dizziness
• Headache

Without treatment, iron deficiency can also spur abnormal food cravings, hair loss, brittle nails, poor concentration, and more.

Assessing Perimenopausal Iron Status

Measuring blood levels helps assess iron reserves. Important tests include:

• Serum ferritin showing iron stored in the body
• Total iron binding capacity measuring blood iron carrying capacity
• Transferrin saturation gauging iron transport efficiency
• Complete blood count detailing red and white blood cell status

Doctors diagnose iron deficiency anemia if red blood cell size, hemoglobin concentration, or iron availability falls below standard thresholds on these blood tests.

Risk Factors for Perimenopausal Anemia

Menstrual Blood Loss

As mentioned, heavier-than-normal periods often occur during the variable hormonal shifts of perimenopause. Losing substantial blood month after month makes replacing depleted iron challenging.

Nutritional Deficits

Even diet variations can impact iron status. Consuming inadequate iron-rich meat, seafood, legumes, spinach and iron-fortified grains may fail supplying enough iron daily.

Factors causing poor nutrient absorption like celiac disease also raise deficiency risk.

Pregnancy History

Each pregnancy uses maternal iron stores to support fetal development. Having multiple closely-spaced pregnancies often drains iron reserves. Prior blood loss from difficult childbirth or uterine fibroids also contributes.

Gastrointestinal Blood Loss

Chronic unseen bleeding within the digestive tract caused by conditions like ulcers, hemorrhoids, cancers or regular use of aspirin/NSAIDs may precipitate iron deficiency over time.

Thyroid Disorder

Thyroid hormones regulate metabolism and the body’s iron utilization. Both overactive and underactive thyroid disease can thereby disrupt optimal iron balance.

Addressing Anemia in Perimenopause

Dietary Iron Intake

Consuming more iron-rich foods aids prevention and correction of deficiency. Great dietary sources include:

• Lean red meat
• Poultry like chicken or turkey
• Seafood, especially mollusks like oysters, clams or mussels
• Legumes including lentils, beans and tofu
• Nuts and seeds like almonds, cashews or pumpkin seeds
• Enriched whole grain products
• Leafy green vegetables like spinach
• Dried fruits such as apricots, prunes or raisins

Pairing iron-containing foods with vitamin C enhances iron absorption. So squeeze lemon on fish, enjoy spinach salads with orange slices, or snack on iron-fortified cereal with strawberries.

Iron Supplements

If diet proves insufficient to resolve perimenopausal anemia, doctors may recommend oral iron tablets temporarily. Ferrous sulfate, ferrous gluconate, ferrous fumarate and iron polysaccharide supplements are frequently suggested.

Work with your healthcare provider to determine appropriate supplemental iron dosing and form based on your blood indicators and other conditions like gastrointestinal issues.

Underlying Cause Treatment

Addressing identifiable contributory causes also helps normalize iron status. This may involve:

• Hormonal medications regulating heavy menstrual flow
• Blood loss prevention via uterine fibroid embolization or endometrial ablation for some
• Treating helicobacter pylori infection or taking proton pump inhibitors if ulcers deplete iron
• Adjusting thyroid medication levels

As menopause approaches and periods cease permanently at the end of perimenopause, iron levels can stabilize for many women.

Staying Iron-Replete Through Menopausal Transition

Paying attention to changing menstrual patterns and potential iron deficiency red flags enables prompt diagnosis and treatment of anemia before exhaustion and problems set in.

Through smart dietary choices, selective iron supplementation when warranted, and addressing underlying medical issues contributing to iron depletion, many women can traverse the perimenopausal years iron-replete and energized.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.