Imagine your life slowly being stolen by fatigue and dizziness, only to discover the culprit is a "hidden" problem affecting a staggering one-third of women. And the worst part? Your doctor might be missing it entirely. That's what happened to Emma Cleary, and it's a story that needs to be heard.
From her early teens, Emma was plagued by light-headedness and crippling exhaustion. Her pale complexion even earned her the cruel nickname 'Casper' from classmates. "I kept going back to the doctors," she recalls, "but eventually I gave up and just started fending for myself. It felt like they just wanted me to put up and shut up." This feeling of dismissal is, sadly, a common experience for many women navigating the healthcare system.
At 16, she was finally diagnosed with anaemia, a condition caused by a lack of iron in the blood, leading to tiredness and a general lack of energy. But here's where it gets controversial... No one ever explained the potential link between her anaemia and her heavy menstrual periods. This is a crucial connection that's often overlooked, leaving countless women suffering needlessly.
Research indicates that one in three women experience heavy menstrual bleeding, also known as menorrhagia. And this is the part most people miss... Many, like Emma, don't even realize they're affected or understand the significant impact it can have on their health. What constitutes a heavy period? It's more than just needing a few extra pads. We're talking about blood loss that actively interferes with your daily life – regularly soaking through pads, tampons, or clothing; needing to change sanitary products every 30 minutes to two hours; or feeling compelled to plan your work and social activities around your period due to the sheer volume of blood.
"I could easily bleed through dresses and down to my socks, so I became really conscious of what I was wearing," Emma explains. "I wore black a lot to try to hide it." But growing up, she just assumed this was normal. It wasn't something she spoke about with friends or even her mum. She assumed this was what everyone was going through, so she just got on with it. This highlights a significant problem: a lack of open conversation and education surrounding women's health issues, leading to normalization of conditions that are far from normal.
Despite her repeated visits to her GP, Emma says her heavy periods were never properly addressed, and the iron supplements she was prescribed offered little relief. The underlying cause – the excessive blood loss – was never tackled.
By her late 20s, working as a model, the impact became impossible to ignore when her hair began falling out. "All women are conscious of their looks, but this was my livelihood," she says. "I would go to shoots and the make-up artists would have to colour in my scalp to make the hair loss less visible." She even spent thousands on a hair transplant, but the problem persisted. Why? Because the root cause – the iron deficiency stemming from heavy periods – remained unaddressed.
Then came the breaking point. "I was queuing in the supermarket one day and felt terrible – dizzy, exhausted and bleeding heavily – but I was just trying to get through," she recalls. "The next thing I knew, I had a face full of flowers. I'd fainted into a display by the till. When I came round, all I could see were flowers, and I genuinely thought I'd died and it was my funeral." She continues, "Then it hit me how embarrassing it was – being 35 years old and having your dad come and pick you up from the shop." This illustrates the very real and often debilitating consequences of untreated iron deficiency anaemia.
It's a fact that premenstrual dysphoric disorder (PMDD) affects about one in 20 women, triggering depression and anxiety before a period, further compounding the misery.
Now 42 and a mother of two, Emma has finally found relief. She has been given a private prescription for tranexamic acid, which reduces menstrual bleeding, and she also receives annual iron infusions. Tranexamic acid works by helping the blood to clot more effectively, reducing the amount of blood lost during menstruation.
"Without it, there's no way I would have been able to start my own business or be a mum to my two boys," she says. "The medication I'm on now is supposed to be available on the NHS – but no one ever asked about my periods when I went to the doctors." This raises a critical question: Why aren't these readily available and affordable treatments being offered to all women who need them?
Experts say such failures amount to a 'silent public health crisis'. Last month, an analysis published in The Lancet by researchers at Anglia Ruskin University found that thousands of women are admitted to hospital every year because of heavy menstrual bleeding.
Dr Bassel Wattar, associate professor of reproductive medicine at the university, said, "This is a silent crisis in women's health. We see thousands of women admitted to hospital for a condition that could often be managed earlier and more effectively in the community. Guidelines and services in the NHS do not provide a clear pathway for managing acute heavy menstrual bleeding efficiently. This mismanagement leads to women being discharged with temporary fixes, often still anaemic, and left to navigate long waiting lists. We need to shift from reactive to proactive care."
The condition, menorrhagia, can be treated with hormonal contraceptives or tranexamic acid. But experts warn that prolonged heavy bleeding frequently leads to iron deficiency. Studies suggest that 36 per cent of UK women of child-bearing age may be iron-deficient – yet only one in four is formally diagnosed.
Iron is an essential mineral, vital for energy levels, cognitive function, digestion and immunity. While most people get sufficient amounts from food – particularly meat and leafy green vegetables – losses caused by heavy periods can quickly outweigh intake. Consider this: while a balanced diet is crucial, it might not be enough to compensate for significant blood loss every month.
"Women with an iron deficiency get dizzy, suffer from shortness of breath and brain fog, and symptoms can be debilitating," says Professor Toby Richards, a haematologist at University College London. "Symptoms are often comparable to – and mistaken for – ADHD and depression." This highlights a dangerous trend: misdiagnosis and the potential for unnecessary medication when the underlying issue is simply iron deficiency.
He is calling for national screening for iron deficiency with a new charity, Shine. In a pilot study at the University of East London, his team screened more than 900 women. One in three reported heavy periods, and 20 per cent had anaemia. Women with iron deficiency were also more likely to report symptoms of depression.
"The Shine pilot has shown how targeted screening can prevent ill health and tackle inequalities," says Professor Amanda Broderick, vice-chancellor and president of the university. "It's already made a real difference for our students – raising awareness of heavy menstrual bleeding and its link to anaemia, and empowering women to take control of their health."
Emma's story and the research findings paint a clear picture: heavy menstrual bleeding and iron deficiency are significant health issues affecting a vast number of women, often going undiagnosed and undertreated. It’s time to break the silence and demand better awareness, diagnosis, and treatment options.
Now, I'm curious to hear your thoughts. Have you or someone you know experienced similar challenges with heavy periods and iron deficiency? Do you think there needs to be more awareness and proactive screening for iron deficiency in women? What steps can be taken to improve the diagnosis and treatment of menorrhagia and iron deficiency anaemia? Share your experiences and opinions in the comments below. Let's start a conversation and help more women get the care they deserve.
