Menopause and Anemia

Iron Deficient Anemia

Up to one third of women may be anemic.  Anemia is often the effect of heavy periods (menorrhagia), other health problems like hypothyroidism, or from medications like antacids or non-steroidal anti-inflammatory drugs. Anemia is diagnosed when a blood test shows a haemoglobin of 12.0g/dL or below . The most common cause of anemia in perimenopausel women is iron deficiency.  Diets low in iron may be the culprit.  Iron rich foods include red meat, fortified cereals, and green leafy vegetables.  Deficiencies in folate and vitamin B12 can also impact iron deficient anemia. Hypothyroidism can cause anemia regardless of type, subclinical hypothyroidism or overt hypothyroidism.  Anemia can also by a symptom of more serious health problems.  Gastrointestinal problems (irritable bowel syndrome, IBS, coeliac disease or parasitic problems) may account for six percent of women with anemia. Infectious diseases, like hook worm, may also be responsible for anemia as can renal disease, auto immune problems and infectious diseases.

Diagnosis of anemia usually starts with blood tests that measure levels of iron, B12 and Folate (folic acid or vitamin M, B9 or Bc).  Liver, thyroid and other tests may also be necessary.

Treatment for anemia

Medical treatments: iron supplements, with B12 and folate  may be recommended. Iron supplements should be taken with vitamin C as this helps with absorption.  Avoid taking calcium supplements or with calcium rich foods as calcium may disrupt iron absorption.  If oral iron does not work then intravenous iron may by prescribed.  Side effects of oral iron can include diarrhea, constipation and abdominal pain, heartburn, blackened stools and feeling ill. Take iron with food if possible.

Once your iron levels return to normal your doctor may recommend you stop taking the supplements after another three months have passed.

Non-medical treatments: revolve around dietary changes. Try to get more protean rich foods. Good sources are: fish, eggs, meat, (red and white). Vegetarian sources include brown rice, nuts and seeds, pulses (beans and legumes) dried fruit, iron-fortified bread and cereals and dark green, leafy, vegetables.

Try to combine vitamin C rich foods or supplements with iron, as it increases absorption.

Avoid taking iron with the following as it reduces absorption: tea or coffee, antacids or proton pump inhibitors (PPIs), wholegrain cereals that have phytic acid as this stops the absorption of iron from other sources, calcium rich foods or supplements.



British National Health Services website. Web page: Iron deficiency anaemia-treatment. Retrieved from:

Cemcor centre for menstrual cycle and ovulation research at UBC website.  Webpage: very heavy menstrual flow.    Retrieved from: website. Webpage: study looks at link between anemia and hypothyroidism. Retrieved from:

Kaushik, G. Midlife and Beyond, GM2 (2009). Anemia in the post-menopausal woman. GM2 Midlife and Beyond, June, 37-40.  From gm journal website, webpage:  Anemia in the post-menopausal woman. Retrieved from:


The information on this site is for educational and informational purposes only.  It is not to take the place of medical advice or treatment.   Seek out a qualified health care provider if you have questions or need help.  Dr. Grant is not responsible for any possible health consequences of anyone who follows or reads the information in this content.  Everyone, but especially those taking medication (over the counter or prescription) should talk with a physician before undertaking any changes to their lifestyle or diet (including taking supplements).