Meera (52), a schoolteacher, had been feeling unusually tired for months. She found it difficult to concentrate, and often felt dizzy or breathless while climbing stairs. She attributed these changes to menopause and her busy lifestyle. During a routine check-up, her haemoglobin (Hb) was found to be 7.8 g/dL (normal levels are between 11 and 14). Further evaluation revealed iron deficiency caused by prolonged heavy menstrual bleeding during her perimenopausal years. With iron therapy, diet changes and treatment, her Hb improved, and so did her energy levels.
Riya (16) felt tired all the time, and had poor concentration and frequent headaches. Her parents assumed it was due to exam stress. During a school health screening, her Hb was found to be 9.2 g/dL, indicating anaemia. Assessment revealed irregular eating habits and frequent junk food consumption, as her iron requirements had increased after her periods started.
These cases show that anaemia is not confined to pregnancy, but affects women at every stage of life.
According to the National Family Health Survey-5, nearly 57 per cent of Indian women aged 15-49 years are anaemic. Anaemia is rising further among Indian women due to nutritional deficiencies, lifestyle changes and increased physiological demands. Many women consume enough calories but their diet lacks adequate iron, vitamin B12, and folate. Frequent dieting, processed foods, menstrual blood loss, closely spaced pregnancies or even pregnancies in general, and poor iron absorption further increase the risk. Delayed diagnosis and irregular intake of iron supplements also contribute.
Another major factor is extreme dieting and meal skipping, particularly among adolescents and young women striving for weight loss. Many follow restrictive diets without nutritional guidance, leading to several severe deficiencies. In many households, women often eat last or eat leftovers. Limited awareness, delayed diagnosis, and poor compliance with iron supplementation further worsen the burden.
Across every stage of life
During adolescence (10–19 years), rapid growth, onset of menstruation, and poor eating habits increase iron requirements, affecting growth, immunity, concentration, and academic performance.
In the reproductive years (20–40 years), menstrual blood loss, restrictive diets, and conditions such as fibroids or endometriosis can gradually reduce iron stores, leading to fatigue, reduced productivity, and poor immunity.
Iron needs increase during pregnancy and after childbirth. Untreated anaemia can raise the risk of preterm birth, low birth weight, postpartum haemorrhage, infections and delayed recovery. It may also affect the baby’s neurological development.
Priya (29) experienced constant fatigue, dizziness, and breathlessness in the second trimester of her pregnancy, but ignored these as normal pregnancy symptoms. A routine check-up later revealed her Hb had dropped to 8.5 g/dL (normal levels are at least above 11). Her diet was low in iron-rich foods, and she had not been taking her iron supplements regularly. With timely iron therapy, diet modifications, and close monitoring, her Hb improved before delivery, reducing the risk of pregnancy-related complications.
During perimenopausal (40–55) years, prolonged or heavy menstrual bleeding is a common but frequently overlooked cause of iron deficiency. Many women attribute tiredness and breathlessness to menopause rather than recognising these as symptoms of anaemia.
After menopause, anaemia is never considered normal and should always be investigated, as it may indicate nutritional deficiencies, gastrointestinal blood loss, chronic kidney disease, or even certain cancers.
The warning signs
Anaemia often develops gradually, making it easy to overlook. Common symptoms include persistent fatigue, weakness, dizziness, headaches, breathlessness, pale skin, hair fall, brittle nails, poor concentration, and reduced exercise tolerance. Never dismiss these symptoms as routine ageing or a hectic lifestyle.
Check with good nutrition
A balanced diet remains the most effective defence. Include iron-rich foods in daily diet like green leafy vegetables, lentils, legumes, dates, raisins, nuts, seeds, eggs, fish, and lean meat. Pair these with vitamin C-rich foods like amla, oranges, guava, tomatoes, or lemon to improve absorption. Cooking in cast-iron utensils can also modestly increase the iron content of food.
Iron supplements should be taken only under medical guidance and never with tea, coffee, calcium supplements, and antacids, as these interfere with iron absorption.
Screening matters
Anaemia often progresses silently before symptoms become severe. A simple blood test can detect anaemia early, allowing timely treatment. Routine screening is must during adolescence, before conception, throughout pregnancy, after childbirth, and around menopause. Women whose Hb does not improve despite iron therapy should be evaluated for other causes, including vitamin B12 deficiency, thyroid disorders, chronic illnesses, or inherited blood disorders. Delayed cord clamping at birth is another simple intervention that improves a newborn’s iron stores and reduces the risk of infant anaemia.