Understanding the Link Between Periods and Anemia

Heavy periods can do more than disrupt your routine—they can actually lead to anemia, a condition where your body doesn’t have enough healthy red blood cells to carry oxygen efficiently.

Your body needs iron to make hemoglobin, the protein in red blood cells that transports oxygen. Losing too much blood during your period can deplete your iron stores. Over time, this can cause iron deficiency anemia, the most common type of anemia in people who menstruate.

Studies show that about 30% of people with heavy periods have low iron, and if the blood loss continues, up to 60% may develop anemia.

How Your Period Can Cause Anemia

Menstrual bleeding leads to iron loss, which can become severe if periods are unusually heavy or prolonged. Anemia develops when your body:

  • Loses too many red blood cells (RBCs) through heavy bleeding

  • Doesn’t absorb enough iron due to digestive conditions like Crohn’s disease

  • Breaks down RBCs too quickly because of autoimmune or heart conditions

  • Fails to produce enough RBCs due to vitamin or hormone imbalances

  • Requires extra iron, as in pregnancy or intense athletic training

When your period regularly causes excessive blood loss, your iron stores can’t keep up—leading to fatigue, weakness, and other symptoms of anemia.

How Much Blood Loss Is Normal?

A typical period causes the loss of about 2–3 tablespoons (30–40 mL) of blood. But if you lose more than 5 tablespoons (80 mL) per cycle, it’s considered heavy menstrual bleeding (menorrhagia).

You may be at risk of anemia if you:

  • Bleed for more than seven days

  • Need to change tampons or pads every hour

  • Pass large blood clots (bigger than a quarter)

  • Experience fatigue or dizziness during your period

  • Must use multiple types of protection at once

  • Frequently wake up at night to change pads or tampons

What Causes Heavy Periods?

Heavy menstrual bleeding has many possible causes. Common factors include:

  • Hormonal imbalances (especially during puberty or perimenopause)

  • Uterine fibroids or polyps

  • Endometriosis or adenomyosis

  • Thyroid disorders

  • Blood clotting problems (like von Willebrand disease)

  • Copper IUDs (can make bleeding heavier in some users)

  • Medications such as blood thinners (e.g., warfarin, aspirin)

  • Chronic illnesses like kidney disease or leukemia

  • Lifestyle factors such as extreme exercise, low body weight, or restrictive dieting

Symptoms of Anemia Caused by Heavy Periods

When your iron stores drop, your red blood cells can’t deliver enough oxygen. This affects your energy, brain function, and overall health.

Menstrual symptoms may include:

  • Irregular or unusually light periods

  • Pale or watery-looking period blood

  • Worsened PMS symptoms (mood swings, headaches, irritability)

General anemia symptoms include:

  • Persistent fatigue and weakness

  • Dizziness or lightheadedness

  • Shortness of breath after light activity

  • Cold hands and feet

  • Pale skin or nail beds

  • Rapid heartbeat

  • Brittle hair and nails

  • Headaches or migraines

  • Craving non-food items (like ice or dirt), known as pica

  • Restless leg syndrome

If you experience these symptoms, consult your healthcare provider for evaluation.

How Anemia Is Diagnosed

A doctor will assess your symptoms, perform an exam, and may order several blood tests to confirm anemia and its cause.

Medical Evaluation

Your provider may check for:

  • Pale skin or inner eyelids

  • Fast or irregular heartbeat

  • Low blood pressure when standing

  • Abdominal tenderness or swelling

  • Changes in nails or skin texture

A pelvic exam or ultrasound may also be done to identify uterine abnormalities causing excessive bleeding.

Common Blood Tests

  • Complete blood count (CBC): Checks hemoglobin and red blood cell levels.

  • Ferritin and serum iron tests: Measure your body’s iron stores.

  • Total iron-binding capacity (TIBC): Evaluates how well your blood transports iron.

  • Reticulocyte count: Measures young red blood cells.

  • Hormone panels: Identify thyroid or reproductive hormone imbalances.

  • Coagulation tests: Detect blood clotting disorders.

Treatment and Management

Iron-Rich Foods

Boosting your iron intake naturally is one of the easiest ways to fight anemia.

Good sources include:

  • Lean red meat and liver

  • Poultry and seafood (clams, oysters, shrimp, sardines)

  • Legumes (lentils, beans)

  • Leafy greens (spinach, kale)

  • Fortified cereals, quinoa, and whole-grain bread

  • Eggs and tofu

  • Dried fruits (raisins, apricots)

  • Nuts and seeds

Tips for better absorption:

  • Pair iron-rich foods with vitamin C (citrus, tomatoes, strawberries).

  • Avoid consuming tea, coffee, or dairy close to iron-rich meals—they block absorption.

  • Vegetarians should aim for 1.8 times more iron than non-vegetarians.

Supplements

If diet alone isn’t enough, your provider may prescribe iron supplements or multivitamins. Always follow medical advice, as excessive iron can cause nausea or constipation.

Medical Treatments

For people whose anemia is caused by heavy bleeding, healthcare providers may recommend:

  • NSAIDs (like ibuprofen or naproxen) to reduce bleeding and cramps

  • Hormonal birth control (pills, IUDs, patches, or injections) to regulate flow

  • Tranexamic acid (Lysteda) or mefenamic acid (Ponstel) to reduce bleeding

  • GnRH treatments or selective progesterone receptor modulators to shrink fibroids

  • Iron infusions or blood transfusions for severe anemia

In certain cases, surgery may be necessary to treat underlying causes:

  • Endometrial ablation (removes uterine lining)

  • Myomectomy (removes fibroids)

  • Uterine artery embolization (shrinks fibroids)

  • Hysterectomy (removes uterus; reserved for serious cases)

Preventing Anemia from Heavy Periods

You can take proactive steps to prevent iron loss and maintain energy during your menstrual cycle:

  • Eat a balanced diet with iron, folate, and vitamins B and C.

  • Track your period to notice any changes in flow or duration.

  • Discuss birth control options that can lighten periods.

  • Avoid skipping meals, excessive exercise, or restrictive diets.

  • Ask your provider about nonhormonal medications to reduce bleeding.

A Quick Review

Heavy menstrual bleeding can lead to iron deficiency anemia, causing fatigue, shortness of breath, and pale skin.

By eating iron-rich foods, taking supplements when needed, and addressing the underlying cause of heavy periods, you can restore healthy iron levels and energy.

If you suspect anemia, consult your healthcare provider for testing and personalized treatment—don’t ignore persistent tiredness or heavy bleeding.