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Feeling lethargic during menstruation is a normal result of the plunge in the hormone estrogen that occurs during this point in your cycle. When the estrogen levels start increasing again, Your energy level should return within a few days. However, if the fatigue lasts longer than that or by tired you mean that you’re totally wiped out all week, there’s probably another cause. You may be suffering from iron-deficiency anemia, especially if you have very heavy periods. Let’s find more about it.

Iron deficiency anemia is a decrease in the number of red cells in the blood caused by too little iron. Iron deficiency anemia is the most common form of anemia. Approximately 20% of women, 50% of pregnant women, and 3% of men are iron deficient. Women of child-bearing age who have blood loss through menstruation and pregnant or lactating women who have an increased requirement for iron are at the higher risk suffer from IDA. During childbearing years, women have a high incidence of iron deficiency anemia because of iron losses sustained with pregnancies and menses. At the first stages of puberty, when a lot of growth occurs, boys are at risk of IDA. Adolescent girls are at higher risk because of menstrual blood loss and smaller iron stores than boys. Many girls also tend to consume a diet low in iron.

Iron is an essential component of hemoglobin, the oxygen-carrying pigment in the blood. Iron is normally obtained through the food in your diet and by recycling iron from old red blood cells. Without it, the blood cannot carry oxygen effectively — and oxygen is needed for the normal functioning of every cell in the body.

The causes of iron deficiency are too little iron in the diet, poor absorption of iron by the body, and loss of blood (including from heavy menstrual bleeding). It can also be related to lead poisoning in children. In men and postmenopausal women, anemia is usually caused by gastrointestinal blood loss associated with ulcers, the use of aspirin or nonsteroidal anti-inflammatory medications (NSAIDS), or certain types of cancer (esophagus, stomach, colon).

The following are the most common symptoms of iron-deficiency anemia. However, each individual may experience symptoms differently. Symptoms may include:

1. abnormal paleness or lack of color of the skin
2. irritability
3. sore or swollen tongue
4. enlarged spleen
5. dizziness or a feeling of being lightheaded
6. lack of energy or tiring easily (fatigue)
7. increased heart rate (tachycardia)
8. a desire to eat peculiar substances such as dirt or ice (a condition called pica)

Iron-deficiency anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, abnormal paleness or lack of color of the skin, or a fast heartbeat (tachycardia). Iron-deficiency anemia is usually discovered during a medical examination through a blood test that measures the amount of hemoglobin (number of red blood cells) present, and the amount of iron in the blood.

Even though most cases of IDA are the result of poor dietary iron intake, diet changes alone usually aren’t enough to replenish depleted iron stores. Likewise, multivitamins with iron aren’t adequate for kids with IDA who have such low iron stores, so a separate daily iron supplement may be required.

Treatments for an IDA sufferer includes:

*Oral iron supplements are available (ferrous sulfate). The best absorption of iron is on an empty stomach, but many people are unable to tolerate this and may need to take it with food. Milk and antacids may interfere with absorption of iron and should not be taken at the same time as iron supplements. Vitamin C can increase absorption and is essential in the production of hemoglobin.

*Supplemental iron is needed during pregnancy and lactation because normal dietary intake rarely supplies the required amount.

*The hematocrit should return to normal after 2 months of iron therapy, but the iron should be continued for another 6 to 12 months to replenish the body’s iron stores, which are contained mostly in the bone marrow.

*Intravenous or intra-muscular iron is available for patients who can’t tolerate oral forms.

*Iron-rich foods include raisins, meats (liver is the highest source), fish, poultry, eggs (yolk), legumes (peas and beans), and whole grain bread.

the image credit by alfonso diaz

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