Anemia - Symptoms That Many Women Regard as Normal

Anemia is often dismissed by women as a sign of stress, lack of sleep, or simply the demands of daily life. Persistent fatigue, difficulty concentrating, pallor, and shortness of breath during routine activities can all be symptoms of this condition. According to data from the World Health Organization, nearly 37% of pregnant women and 30% of women aged 15 to 49 suffer from anemia globally. These figures highlight a widespread issue affecting millions of women worldwide. Anemia occurs when the blood lacks sufficient healthy red blood cells or adequate levels of hemoglobin, the protein responsible for carrying oxygen to tissues. As a result, the body receives less oxygen than needed, leading to a range of symptoms that may go unnoticed for months. Women in their reproductive years are particularly vulnerable due to regular menstrual bleeding, especially when periods are heavy or prolonged. This loss of iron over time increases the risk of developing anemia. Dr. María Soledad Undurraga, a hematologist at Clinica Universidad de los Andes, explains that many women fail to recognize abnormal menstrual flow as a potential cause of anemia. She notes that there is no clear standard for what constitutes normal bleeding, and such discussions are rarely initiated. “Many minimize very heavy menstruation and seek medical attention only when exhaustion becomes severe,” she says. Furthermore, since iron loss happens gradually, women often delay seeking help until anemia has already developed. Dr. José Luis Briones, a clinical hematologist with expertise in precision medicine and genetics, agrees. He emphasizes that women are more susceptible to factors that reduce iron stores, including menstruation, pregnancy, and breastfeeding. The severity of anemia depends on several variables, such as the extent of menstrual bleeding, dietary iron intake, and proper supplementation during pregnancy. However, he warns that anemia can occur at any stage of life, and its causes change with age. “Later in life, anemias may no longer stem from iron deficiency, so it’s crucial to consult a healthcare provider whenever symptoms deviate from the norm,” he adds. Pregnancy represents another critical period, as the body's iron requirements increase significantly to support fetal development and placental formation. If these reserves are not replenished after childbirth, the risk of ongoing anemia persists into the postpartum phase. During this time, the body continues to require nutrients for recovery and, in many cases, for breastfeeding. Dr. Briones highlights that maternal iron deficiency can impact both the pregnancy and the child’s neurological and cognitive development. “The mother must expand her blood volume and mobilize her iron stores to produce the baby’s red blood cells, especially during the second and third trimesters,” he explains. Supplementation with iron may be necessary under certain conditions. In general, a balanced diet provides enough iron for most individuals. However, situations such as heavy bleeding, digestive disorders that impair absorption, or high-demand phases like pregnancy make dietary intake insufficient. “When bleeding is significant, or when digestion is compromised, or during times of heightened nutritional need, iron supplements prescribed by a physician become essential,” says Dr. Briones. Dr. Undurraga adds that individuals with normal intestinal absorption and a well-rounded diet, including animal proteins like meat, poultry, or fish, typically do not require additional iron. Exceptions include women experiencing extremely heavy menstrual cycles. In such cases, not only should they take iron supplements, but they should also consult a gynecologist to investigate possible underlying issues causing excessive blood loss and address them accordingly.