Low Iron After Menopause:4 Common Causes and Solutions

Last updated 01.12.2024 | by Sabrina Johnson | 9 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

Of the several nutrients a woman needs, iron is one of them. Iron helps to transport oxygen effectively throughout your body. Women are more prone to iron deficiency than their male counterparts because of the blood loss that they go through during menstruation. In fact, around a milligram of iron is lost per menstrual cycle. Women with heavy bleeding can lose iron at 1.5 mg daily. That’s why maintaining your iron intake throughout your life is essential.

When I stepped into my 40s, my doctor would often stress on maintaining my iron levels. Besides advising me on a healthy diet, she had even prescribed supplements as my iron levels had dipped a little after my 40s.

I was reading a review by the NHLBI ( National Heart, Lung, and Blood Institute), which mentioned about 20% of females below 50 have iron deficiency. When you pass the menopausal stage and step into postmenopause, your iron requirement gets lesser than before.

However, iron deficiency could continue in postmenopause, too, especially if you don’t make an effort to manage your diet and do everything else to keep your iron levels in check. In postmenopause, lessened iron levels in the blood could even occur due to other reasons. Would you want to know why the iron levels lower after menopause?

You may also be wondering how to manage your iron levels in menopause and the time that follows. Right? This article will be of help then. I have touched upon some of the most important aspects here, like the reasons for low iron levels after menopause. I have even elaborated on the symptoms and management techniques. Read on to know more.

Why Does Your Iron Intake Lower with Menopause? 4 Possible Causes

Why Does Your Iron Intake Lower with Menopause 4 Possible Causes

It is essential to know that iron intake also lessens as a woman ages. Women between 19 and 50 need an average iron intake of around 18 mg daily. However, those who are 51 and above require a much-reduced iron intake, at most 8mg daily. However, despite the fact that a woman’s iron intake lowers after menopause, she may still be deficient in the mineral because of several reasons. Here are some of the causes for a reduction in your iron levels during the postmenopause phase.

1. Malabsorption of Iron

Malabsorption happens when the body loses the ability to absorb iron from food sources. This results in iron deficiency anemia. This mainly occurs when an abnormality in the GI (gastrointestinal tract) alters iron absorption.

In postmenopausal women, malabsorption is one of the prime reasons for low iron levels, leading to anemia. This fact has been highlighted through a study conducted on 123 women in the postmenopausal phase. The results deduced that postmenopausal women were susceptible to iron malabsorption at 6.8%.

2. Gastrointestinal Disorders

This is an extension of the above point, as malabsorption mainly occurs due to gastrointestinal disorders.

In menopause, most body functions go for a toss due to hormonal imbalances. Your digestive system is also affected due to the hormonal fluctuations. Digestion is prolonged, and this could result in problems like bloating, increased gas, and constipation. If you have pre-existing digestive system problems like celiac disease, irritable bowel syndrome, or gastritis, with menopause, it will aggravate further. When digestion is improper, it increases the chances of malabsorption, leading to decreased iron levels.

3. A Result of Frequent Blood Donation

In postmenopause, you could be at risk of low iron levels, especially if you have gastrointestinal problems that trigger malabsorption. Now, if you are into frequent blood donations, like donating blood in two months, then it could affect your hemoglobin levels, irrespective of whether you are in menopause or not. As you approach and experience menopause, it could affect your iron levels immensely.

A medical practitioner had presented a case of his wife, who donated blood quite frequently – five times a year. She was diagnosed with anemia and referred for a colonoscopy. When her colonoscopy reports turned out to be normal, she was advised to have an endoscopy of the upper GI. The actual cause was her frequent blood donations. Doctors recommend regular donors with low hemoglobin to start iron supplements or temporarily refrain from donating blood.

If you are in your late 40s or 50s and have been into frequent blood donations, it is time that you make changes in the same. You may even have a word with your doctor on this.

4. An Improper Diet (Sans Meat)

If you are a vegan or vegetarian and do not eat meat, you will likely be iron-deficient, especially if your iron requirements aren’t met well from other sources. Your iron levels will also fall when you aren’t getting sufficient vitamin B12 derived from poultry, meat, fish, milk, and eggs.

That’s why it is essential to maintain a balanced diet even when you are a vegetarian or vegan and ensure that your body gets sufficient iron and other nutrients from other sources if not meat or dairy products.

Symptoms of Low Iron Levels (Anemia)

Symptoms of Low Iron Levels (Anemia)

When iron deficiency is mild, you may not have any noticeable symptoms. It could be during routine bloodwork that the condition gets diagnosed. That’s what happened to me. I had gone for my yearly checkups when it was detected that my iron levels were a little lower than the normal range. In moderate or severe anemia, you could experience the following symptoms:

  • Chest pain
  • Increased heartbeat
  • Shortness of breath
  • Increased fatigue and weakness
  • Cold hands or feet
  • Brittle and misshapen nails
  • Headaches (mainly after physical exertion)
  • Pale skin
  • Cravings for non-food items sans nutritional value

The symptoms mentioned above are more common in individuals with anemia. There are some less common symptoms also, as follows:

  • Pulsatile tinnitus (where the heartbeat or pulse is heard in the ears)
  • Altered taste
  • Feelings of itchiness
  • Change in tongue texture (smooth, glossy, or sore)
  • Swallowing difficulties
  • Open sores (in your mouth’s corner)

Ways to Manage and Treat Low Iron Levels in Postmenopause

If you have experienced menopause and are going through any one or a combination of the symptoms mentioned above, then it could be that your iron levels are low, and it may even have manifested into anemia if you are increasingly deficient in this mineral. Here are ways to treat and manage iron levels.

1. Seek Medical Help

Even before you think about management measures to cope with low iron levels, the first thing you should do when you face discomfort is to contact the doctor. He will check your symptoms and even recommend blood work to diagnose anemia. He may even recommend an endoscopy or a colonoscopy to check for GI and colon bleeding.

The treatment depends on how severe your anemia is. In most cases, iron supplements help to elevate iron levels. However, IV (intravenous) iron supplements may be needed in extreme cases to increase the levels. If the iron deficiency is due to GI bleeding, IV iron therapy, transfusion, or surgery may be recommended if the iron deficiency is due to GI bleeding.

2. Maintain a Healthy Diet

Diet plays a significant role in ensuring your essential nutrients are maintained well. When talking about foods rich in iron, the ones that top the list include:

  • Red meat
  • Poultry
  • Pork
  • Bread and iron-fortified cereals
  • Brown rice
  • Fish and other seafood
  • Dried fruits like prunes, raisins, and dried apricots

If you are a vegetarian or vegan, then there is an array of foods you can include to boost your iron levels. These include:

  • Legumes (beans, lentils, and peas)
  • Seeds and nuts (Macadamia, almond, pumpkin seeds, flaxseeds, sesame seeds, pine nuts, cashew)
  • Leafy greens (broccoli, kale, spinach, bok choy)
  • Fruits (apples, pomegranate, strawberries, watermelon, prunes, date palm)
  • Whole grains (quinoa, oats)

As mentioned, in menopause, you need less iron than in your reproductive years. So, if you have been diagnosed with low iron levels in your blood in postmenopause, it is always advisable to have a word with the doctor before making any dietary changes. If you exceed your iron consumption, that could bring in trouble.

Another word of caution. If you swear by tea and coffee, knowing that these beverages reduce your body’s iron absorption is essential. In a study, it was shown that when you have a combination of a hamburger meal and coffee, iron absorption is lessened by around 39%.

Contrastingly, a blend of tea and a hamburger meal reduces your body’s iron absorption by approximately 64%. The stronger the tea or coffee, the lower the iron absorption. So, you should not just eat healthily but avoid triggers that lower your body’s iron levels.

It took me a lot of effort to cut down on coffee consumption when I realized that I was transitioning into menopause. From four cups a day, I brought it down to a cup a day. On some days I go without coffee as well. That’s a big thing for a coffeeholic like me to do.


Should postmenopausal women be given iron supplements?

Recent research has highlighted the risk of postmenopausal women from being affected with iron deficiency. Despite these findings, iron supplements aren’t advisable, at least not without consulting a doctor.
There hasn’t been any research to deduce that iron supplements lessen the risk of postmenopausal women from being affected with anemia. Instead, to up your iron levels, go for a balanced diet. That will help you better.

How do you increase your iron levels fast?

That is a misstatement. There isn’t a way you can increase your iron levels fast. It’s a slow and gradual process. When you have reduced iron levels, talking to the doctor is the first thing you must do. Also, following a proper diet of leafy grains, legumes, nuts, seeds, poultry, and meat will help raise iron levels.

Which drinks have a high iron content?

Here is a list of the iron-rich drinks to have if you are iron-deficient. These include: 
• Apple juice
• Orange juice
• Spinach juice
• Prune juice
• Tomato juice
• Smoothies made with kale, spinach, celery, parsley, mint, or cucumber
Smoothies have always been my favorite, and I love to make a delicious blend of spinach, avocado, banana, and milk. It’s a healthy and tasty treat indeed.


There needs to be more research to underline the specific causes of iron-deficient anemia in postmenopausal women. This aspect needs more studies. In most cases, postmenopausal anemia isn’t a cause for concern and can be corrected with prompt treatment and proper diet. When you have alarming symptoms like shortness of breath or increased fatigue, do not disregard it as one of the postmenopausal side effects. If the symptoms prolong, contact your healthcare provider instantly.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.