Iron Deficiency Anaemia in Women: Signs, Causes and Treatment

Anaemia is very common among women in Pakistan, and iron deficiency is its leading cause. Many women live with it for years, putting the tiredness down to housework, studies or a busy job. The good news is that iron deficiency anaemia is easy to test for and usually straightforward to treat.

What is anaemia?

Anaemia means you have fewer healthy red blood cells or less haemoglobin than normal. Haemoglobin carries oxygen around the body, so when it is low, every organ gets a little less oxygen. For adult women, the World Health Organization defines anaemia as a haemoglobin level below 12 g/dL, and below 11 g/dL during pregnancy.

Signs and symptoms

• Tiredness and weakness that does not improve with rest
• Pale skin, pale inner eyelids or pale nails
• Shortness of breath or a pounding heart on light activity
• Dizziness and headaches
• Cold hands and feet
• Hair fall and brittle or spoon-shaped nails
• Cravings for ice, clay (mitti) or uncooked rice, known as pica

Common causes

• Heavy periods, the most common cause in women of reproductive age
• Pregnancy and breastfeeding, when the body needs much more iron
• A diet low in iron, or drinking tea with meals, which blocks iron absorption
• Intestinal worms, especially in children and in rural areas
• Frequent pregnancies close together
• Stomach conditions that reduce absorption, or slow bleeding from the gut

Tests

A complete blood count (CBC) shows your haemoglobin level. A serum ferritin test shows how much iron your body has stored; low ferritin confirms iron deficiency. Your doctor may look for the underlying cause, particularly if your periods are very heavy or there is any sign of bleeding.

How iron supplements are used

Oral iron is the usual first treatment. It comes in several forms, including ferrous salts and iron polymaltose, often combined with folic acid. To get the most from it:

• Take it as directed, ideally on an empty stomach or with a glass of orange juice, as vitamin C helps absorption.
• Keep a gap of at least 1 to 2 hours between iron and tea, coffee, milk, calcium tablets and antacids.
• Expect dark stools; this is harmless. Constipation or stomach upset can occur, and taking it with food or switching the form can help.
• Keep taking it for about 3 months after your haemoglobin returns to normal, to refill your iron stores.

Haemoglobin usually starts to rise within 2 to 4 weeks. If it does not, or if you cannot tolerate tablets, doctors may recommend an iron infusion.

Iron-rich foods

• Red meat, liver, chicken and fish, which contain easily absorbed iron
• Daal, chana, lobia and other pulses
• Spinach (palak), methi and other dark green leaves
• Eggs, dates, dried apricots and jaggery (gur)

Pair plant sources with vitamin C foods such as lemon, tomatoes, guava or oranges, and save tea for between meals.

Anaemia in pregnancy

Iron needs almost double in pregnancy. Untreated anaemia raises the risk of premature birth, low birth weight and heavy blood loss at delivery. Most doctors advise iron and folic acid supplements throughout pregnancy. See our pregnancy care range.

When to see a doctor urgently

Seek help quickly if you have chest pain, fainting, severe breathlessness, black or bloody stools, or very heavy bleeding.

Key takeaways

• Low iron is a very common cause of tiredness in women.
• A CBC and ferritin test confirm it.
• Take iron away from tea and milk, and continue for around 3 months after levels normalise.
• Find and treat the cause, such as heavy periods or worms.

Browse iron supplements for anaemia on Medimart.

This guide is for general information and does not replace advice from a doctor.