Heavy periods and breathlessness: could it be low iron?

How do I know if my periods are too heavy?

There are concrete markers. According to the NHS, periods are heavy when you need to change your pad or tampon every one to two hours or use two types of product together, when bleeding lasts more than seven days, comes through to your clothes or bedding, or includes clots larger than about 2.5cm. The American College of Obstetricians and Gynecologists uses a similar threshold: soaking through one or more pads or tampons every hour for several hours in a row.

Many women have lived with periods like these since their teens and assume they are ordinary. They are common, which does not mean they are without consequence: repeated blood loss is one of the causes of iron deficiency anaemia.

Why does low iron leave me out of breath?

Because your blood carries oxygen less well. Anaemia occurs when haemoglobin, which carries oxygen to the organs and tissues, falls below normal, and a lack of iron is often the cause, the World Health Organization explains. The symptoms creep in quietly: tiredness, dizziness, cold hands and feet, headaches, shortness of breath especially on exertion, and a reduced capacity for physical work.

For a woman who trains regularly, it looks like a dip in form. WHO estimates that anaemia affects 30% of women aged 15 to 49 worldwide, 106 million of them in its African region. But these signs are not specific to iron. Malaria, sickle cell disease and a lack of vitamin B12 or folate produce the same picture.

Can I just take iron myself?

No: iron is taken on medical advice, after a blood test. The doctor asks about your health and lifestyle, then orders a full blood count, often with iron and ferritin levels. The results show whether you are anaemic, whether iron is involved and, above all, why. WHO itself limits supplements to cases where a qualified health-care provider recommends them.

Supplementing blind raises three problems. You risk missing the real cause, whether heavy periods that can be treated or another condition. The tablets have well-known side effects on the gut. And a box of iron left within reach of a young child is dangerous: an overdose can be fatal, the NHS warns. When treatment is prescribed, it lasts several months and is monitored with repeat blood tests.

What should I eat while I wait for the results?

Foods rich in iron, paired with vitamin C. WHO lists lean red meat, fish and poultry, legumes such as lentils and beans, fortified cereals and dark green leafy vegetables. Fruit and vegetables rich in vitamin C help the body absorb iron, so a piece of fruit or a glass of orange juice at the same meal works in your favour.

Tea, coffee and cocoa, on the other hand, slow that absorption when they accompany an iron-rich meal. The glass of tea that follows the main dish is better moved to another time. Food helps; it replaces neither the blood test nor prescribed treatment.