Iron deficiency and fatigue in perimenopause

Many women entering their 40s and early 50s notice changes in their energy levels.

While busy schedules, work demands and family responsibilities often play a role, another factor that is sometimes overlooked is iron status.

Iron deficiency is one of the most common nutrient deficiencies in women, and it can become particularly relevant during perimenopause, when menstrual cycles may become irregular or heavier.

Low iron levels can contribute to fatigue, reduced concentration and decreased productivity — symptoms that many women mistakenly attribute to stress or simply getting older.

Why iron is important

Iron is essential for carrying oxygen throughout the body.

It is a key component of haemoglobin, the protein in red blood cells that transports oxygen from the lungs to tissues and organs.

When iron levels are low, the body’s ability to deliver oxygen efficiently can be affected.

This can lead to symptoms such as:

• persistent fatigue
• reduced concentration
• headaches
• shortness of breath during exercise
• decreased exercise capacity

These symptoms can have a noticeable impact on day-to-day functioning, particularly for women balancing work, family responsibilities and other commitments.

Why perimenopausal women may be at risk

Perimenopause is the transition leading up to menopause, and during this time hormonal fluctuations can cause changes in menstrual patterns.

Some women experience:

• heavier periods
• longer periods
• more frequent cycles

These changes can increase iron losses and may contribute to iron deficiency if dietary intake is not sufficient.

Because the symptoms of low iron often develop gradually, they can easily be overlooked or attributed to other causes.

Iron and cognitive performance

Iron plays an important role not only in physical energy but also in brain function.

Research has shown that iron deficiency can affect cognitive performance, including attention, memory and mental clarity.

For women in demanding roles at work or managing busy households, these changes can have a real impact on productivity and overall wellbeing.

Iron-rich foods

Including iron-rich foods regularly can help support healthy iron levels.

Examples include:

• lean red meat
• poultry
• fish and seafood
• eggs
• legumes such as lentils and chickpeas
• tofu and tempeh
• iron-fortified cereals
• leafy green vegetables

Iron from animal foods is generally more easily absorbed than iron from plant foods.

However, combining plant sources with vitamin C-rich foods (such as citrus, berries or capsicum) can help improve absorption.

When to seek advice

If symptoms such as fatigue, reduced concentration or shortness of breath persist, it may be worth discussing iron status with a healthcare professional.

Blood tests can assess iron levels and determine whether supplementation or dietary changes may be needed.

Supporting energy through nutrition

For women navigating perimenopause, maintaining adequate iron intake is one of several nutrition strategies that can support energy and wellbeing.

Alongside iron, nutrients such as protein, vitamin B12 and overall energy intake also play important roles in supporting physical and mental performance.

Paying attention to nutrition during this stage of life can help women maintain energy levels, support productivity and feel their best during a time of significant physiological change.

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