Chronic Fatigue: Is it iron deficiency or menopause?

Fatigue is one of the most common complaints among women in midlife. But when tiredness persists, it’s not always clear whether menopause, iron deficiency or both are to blame.

Why fatigue happens

Hormonal changes during the menopause transition often disturb sleep, mood and concentration. Many women experience exhaustion, brain fog and irritability.

Yet iron deficiency can also be a culprit, even after menstruation has ended.

Reduced iron absorption, chronic inflammation, certain medications or hidden blood loss can all lower iron stores, leaving you drained.

Spotting the difference

Menopause and iron deficiency share many symptoms: tiredness, poor focus, mood swings and restless nights. 

However, iron deficiency can also provide additional clues, such as brittle nails, hair loss, pale skin, or feeling unusually cold, due to the significant overlap. A blood test is the most reliable way to find answers to this. 

Checking ferritin and related markers can also show whether low iron is part of the picture

What you can do

Start with food: lean meat, lentils, spinach, nuts and seeds paired with vitamin C help boost iron intake. If that’s not enough, your doctor may recommend supplements or, in more severe cases, iron infusions. At the same time, lifestyle habits like managing stress, prioritising rest and staying active support both hormonal health and energy levels.

Final words 

Persistent tiredness shouldn’t be dismissed as “just menopause”. Iron deficiency may be an overlooked factor, and identifying it can make a real difference to your energy, mood and overall wellbeing.

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