“It’s all just too much.” It’s a common refrain among women over 25, yet behind the fatigue, anxiety and burnout could lie a hidden medical issue: iron deficiency anaemia in women. Health experts are increasingly urging both medical professionals and patients to consider iron-related issues such as anaemia as a serious but treatable cause of overwhelming exhaustion. The lack of iron in the body can lead to various symptoms that are often mistaken for other conditions.
Though iron deficiency anaemia is one of the most common nutritional disorders globally, it’s rarely top of mind when women present symptoms like brain fog, low mood or hair loss. Many dismiss these signs as the by-products of a fast-paced life. However, growing evidence suggests that iron deficiency and anaemia are significantly underdiagnosed, especially in women of childbearing age.
The heavy load women carry
Across the world, women are navigating careers, raising children, building relationships and caring for ageing parents. While doing all of this, they often push through tiredness and mental fog, normalising a level of exhaustion that may be far from normal.
In fact, recent research shows that anaemia affects around 30% of women aged 15–49 worldwide. In Africa, the numbers are even higher, with 43% of reproductive-age women affected. “We’re seeing women in their 20s, 30s and 40s who feel like they’re drowning physically and emotionally, and it’s being normalised as just ‘part of modern life’,” says Sister Karin Davidson, anaemia awareness advocate and head of the Cape Town Infusion Centre.
Iron deficiency in women: the hidden symptoms
Typical symptoms of anaemia—like fatigue, dizziness, pale skin and heart palpitations—are well documented. But Sister Davidson warns of less obvious signs that women often overlook. “Low iron can also manifest as persistent anxiety, depression, sleep disruption and cognitive difficulties. These are symptoms women live with daily without realising they may be medical in origin,” she says. Additionally, shortness of breath and chest pain can be indicators of severe anaemia.
Iron plays a vital role in the production of red blood cells and serotonin, the hormone that regulates mood and sleep. When iron levels are low, your body can’t make enough of this “happy chemical” or sufficient red blood cells, which has a significant effect on mental and emotional well-being, as well as overall health. Some women may even experience unusual cravings or notice brittle nails as a result of being anaemic.
Normalised menstrual bleeding and its impact
Another overlooked factor is menstrual health. “Heavy menstrual bleeding is one of the leading causes of iron deficiency anaemia in women,” explains Sister Davidson. “Up to 50% of reproductive-age women may experience heavy periods, contributing significantly to anaemia. Compounding this is the fact that girls today are starting menstruation earlier than previous generations.”
When excessive blood loss is dismissed as routine, women can live for years with declining iron levels, unaware that this is what’s draining their energy and potentially leading to low haemoglobin and low ferritin levels.
Who is at risk?
Working women
Irregular eating habits and workplace stress often lead to reduced iron intake. “The modern working woman may blame her fatigue on career demands,” says Davidson. “But if the exhaustion is relentless, it’s time to consider iron testing and checking ferritin levels.”
Vegans and vegetarians
Plant-based diets can put women at risk if not properly managed. “We’re seeing more women self-designing their diets, unaware they may be missing key nutrients,” she warns. It’s crucial to include iron-rich foods like leafy green vegetables, dried fruits and consider iron supplementation to prevent inadequate iron intake.
Athletes
High levels of physical activity increase iron demand. Without sufficient dietary support, including iron-rich foods like red meat, active women are more vulnerable to iron depletion and anaemia.
Frequent blood donors
Women who regularly donate blood are at higher risk of developing iron deficiency anaemia due to the repeated loss of iron-rich red blood cells.
Iron deficiency in women: the path to diagnosis and treatment
A simple blood test can uncover low iron stores or anaemia. Medical professionals recommend full iron studies, not just a standard haemoglobin test. This includes checking serum iron levels, iron saturation, and a complete blood count to get a comprehensive picture of iron status.
For mild cases of iron deficiency anaemia, oral iron supplements or iron tablets may be effective, though they require proper use over time. In moderate to severe cases, intravenous iron infusions are often the quickest and most effective option for anaemia treatment. “Many women feel significant relief after just one or two iron infusions,” says Davidson.
Taking control of your health
Sister Davidson’s advice is clear: “Think Iron. Check Iron. Take Iron. Your future self will thank you for it.”
If you suspect you may be affected:
- Track your symptoms and menstrual cycles.
- Request comprehensive iron testing from a medical professional.
- Don’t settle for vague answers—get a second opinion if needed.
- Consult a registered dietitian if following a restrictive or plant-based diet.
Did you know?
- You can’t correct anaemia by diet alone.
- Tea and coffee interfere with iron absorption.
- Vitamin C improves iron absorption from food, so consider drinking orange juice with iron-rich meals.
- Intravenous iron may be covered by medical aid in South Africa if clinically necessary.
- Only trained professionals should administer IV iron in licensed medical facilities.
By understanding the impact of iron deficiency anaemia and taking proactive steps, women can reclaim their energy and improve their overall quality of life. Don’t let iron deficiency hold you back—take charge of your health today. Whether through dietary changes, iron deficiency treatment, or anaemia treatment, there are solutions available to help you feel your best.
