Is PMS putting you at risk of anemia?

Some common signs of iron deficiency to look out for


Sonia Chartier

24 April 2019

What's anemia?

Iron deficiency anemia, or anemia for short, is caused by a lack of iron. Iron is an important mineral that helps make up hemoglobin, the unique component of your red blood cells that transports oxygen around your body. Without enough iron, you risk lacking healthy, oxygen-saturated red blood cells, which can leave you feeling lethargic and drained.
Anemia is more common in women than men, and common causes include pregnancy (when you use up more iron stores) and heavy menstrual bleeding. During heavy periods, you lose more of your iron stores and risk not being able keep up with the loss each month.
Iron deficiency anemia can gradually become worse as your body attempts to make up for the lost red blood cells by desperately using up your iron stores to make more hemoglobin, resulting in your iron stores quickly becoming drained. Heavy or frequent periods as a result of PMS, perimenopause or conditions such as endometriosis or fibroids may increase the likeliness of this condition.

What your doctor might not be telling you

Anemia is quite often suspected if someone complains of feeling tired all of the time. However, you should be aware of some important points regarding anemia.
Men are much less likely to be anemic
While iron is often prescribed as a universal supplement for those struggling with fatigue or tiredness, a lack of iron isn't always the culprit. Therefore, men and even women who haven't had their levels checked recently shouldn't take this mineral unnecessarily. Yes, women are generally more likely than men to be low in iron, but interestingly, if you don't bleed (or bleed enough), you can actually struggle to excrete iron, so stocking up on extra iron and not losing any can cause it to build up in your body and put pressure on your liver as it struggles to process or eliminate the excess.
If you're getting your iron levels checked, have your ferritin levels checked too
Your doctor will most likely check your hemoglobin levels initially if she or he suspects that you could be anemic. And yes, this can certainly be a good indicator of anemia, as hemoglobin levels do provide a good indication of the quantity of iron circulating in your body. However, for an even better gauge of what's going on, it's best to look at your ferritin levels. Ferritin is the stored form of iron, and if your ferritin levels are depleted, it suggests that you need some extra support.
Prescribed iron may not be the best option
While iron supplements are a sensible choice if you're anemic, prescribed iron tablets aren't always the best option. Cheaper forms of iron such as ferrous sulphate may contribute to digestive issues such as constipation, and we know that this can contribute to uncomfortable symptoms and potentially put pressure on your liver.

Some of the main causes of anemia aren't "normal"!

Unfortunately nowadays, it's far too "normal" to be bleeding heavily during your period! We often hear of women going to the doctor and being told that what they are experiencing is normal and just a part of being a woman. However, while we know that heavy bleeding is often quite common at certain stages of a woman's life, for example as a result of PMS or perimenopause, we actually need to do something about it, as ultimately it can make us anemic and quite unwell! Initially, if the bleeding is very heavy and showing no signs of slowing, then it's likely that you need some short-term hormonal intervention from your doctor to help get things under control. In the long term, a good-quality iron tonic and some Agnus castus may be a suitable solution for you.

Anemia isn't always linked to your menstrual cycle
We'll touch on this a little later too, but for now, just know that anemia isn't always linked to blood loss, even though it is usually the main contributing factor. Digestive issues can also have an impact. You may be struggling to absorb iron from your diet and replenish your stores because of digestive problems. First, you need good, strong stomach acid to absorb iron sufficiently (many of us are severely lacking), but conditions such as celiac disease (especially if undiagnosed) may also be having an impact, affecting how you absorb nutrients from your food. In extreme cases, black, tarry stools could also suggest that you're losing blood internally, which of course could be contributing to anemia; if this is the case for you, see your doctor immediately.

Some of the common symptoms to look out for

If you suspect you could be anemic, common symptoms to look out for include:

  • Fatigue or a feeling of weakness
  • Poor concentration
  • Pale skin, often with the appearance of dark circles around the eyes
  • Irritability
  • Colder hands and feet
  • Sexual dysfunction
  • Hair loss
  • Pica: cravings for non-food items such as ice, charcoal or even sponges to chew on
  • Change in the appearance or texture of the tongue

Some more serious symptoms:

  • Palpitations
  • Recurrent headaches
  • Dizziness
  • Shortness of breath

Many of these symptoms may be related to anemia or something else, so if you're ticking some of those boxes, it's time to go to the doctor for a formal diagnosis. Also, if you experience any of the symptoms in the second list, you should visit your doctor for a check-up sooner rather than later.

What you can do at home to help protect against it

If you've been told you have anemia, some simple steps at home can help you manage the condition:
Stock up on iron-rich foods
As well as good quality red meat—keeping in mind that a growing body of experts now recommend not eating it too often—there are also some good plant-based sources of iron worth considering. Stock up on green, leafy vegetables (kale, mustard greens, Swiss chard, etc.), pulses (a.k.a. legumes, like beans, lentils, chick peas and peanuts), brown rice and dried fruit to boost your daily intake.

Support your stomach!
As mentioned above, it's really important to look after your digestive system to maximize your absorption of iron. First, you need sufficient stomach acid, so if you feel that you could use some extra support, consider trying some herbal bitters such as Yarrow.

Watch your consumption of tea
Tannins, compounds found in tea, may also affect the absorption of iron from your meals. We advise avoiding drinks with your meals anyway, but this is especially true if your drink of choice is black tea. Separate your drinks from meals and couple iron-rich foods with vitamin C-containing foods instead, as they are known to support iron absorption.

What about supplements?

Lastly, if you've recently discovered that you're anemic, it's sensible to support yourself with some supplements too.
Bio-Strath, on its own, does not contain enough iron to be considered an iron supplement. However, it does optimize the absorption and assimilation of iron from a normal, healthy diet.
Agnus castus
If heavy periods are the root cause of your anemia, then it makes sense to tackle this issue head on. Agnus castus helps gently support your progesterone levels, which can in turn help dampen the typical estrogen-dominant symptoms that often give rise to heavier, more painful periods.