Quick Answer
Yes, it is common for women to feel tired or fatigued during their period, especially if they are losing a large amount of blood. The medical term for losing an excessive amount of blood during menstruation is menorrhagia. Menorrhagia can cause iron deficiency anemia, which is a lack of healthy red blood cells in the body due to too little iron. This anemia is a major cause of fatigue and tiredness in women with heavy periods.
What Causes Period Fatigue
There are several reasons why heavy periods are linked to fatigue:
Blood and Iron Loss
During a normal period, women lose about 30-40 milliliters of menstrual fluid on average. With menorrhagia, it’s not uncommon to lose 80 milliliters or more of blood and fluid each cycle.
This heavy monthly blood loss results in excessive iron loss. Since iron is required to produce hemoglobin in red blood cells, low iron reduces the oxygen-carrying capacity of blood. Without enough hemoglobin and RBCs, tissues and muscles quickly become deprived of oxygen. This leads to the feelings of weakness, tiredness, and fatigue during periods.
Anemia
The iron deficiency from heavy periods can eventually lead to iron deficiency anemia. This is characterized by abnormally low hemoglobin levels.
Anemia starves the tissues of oxygen and makes the heart work harder to compensate. This added cardiovascular stress, as well as the lack of oxygen reaching muscles, leads to excessive fatigue and tiredness. Studies show that women with iron deficiency anemia report lower energy levels and greater fatigue.
Other Nutrient Losses
Along with iron, heavy menstrual bleeding leads to excessive losses of other nutrients like vitamin B12, folate, and vitamin C over time. Deficiencies in these nutrients can cause fatigue.
Disrupted Sleep
The need to frequently change pads/tampons at night can interfere with sleep quality. Poor sleep exacerbates common period symptoms like tiredness, irritability, and fatigue.
Who is Most Affected
Women with the following conditions tend to be most affected by period-related fatigue:
- Menorrhagia or heavy periods
- Uterine fibroids which can worsen heavy bleeding
- Endometriosis
- Blood clotting disorders
- Hypothyroidism
- Pelvic inflammatory disease
- Cervical stenosis
- Adenomyosis
- Certain IUDs like Paragard may increase blood flow
- Women with copper deficiency
Teen girls who just begun menstruating are also very prone as their bodies are still adjusting to cyclical blood loss.
Older women approaching pre-menopause may struggle with fatigue from heavy periods as their ovarian function declines.
Effects of Fatigue From Heavy Periods
Physical Effects
– Muscle weakness
– Decreased endurance/stamina
– Dizziness
– Headaches
– Irregular heart rate
– Shortness of breath
– Pale skin
Mental Effects
– Poor concentration
– Difficulty focusing
– Mental fogginess
– Increased risk of accidents
– Impaired cognition
– Poor memory
Emotional Effects
– Increased irritability
– Mood changes
– Anxiety
– Depression
Lifestyle Effects
– Impaired daily functioning
– Need for longer sleep
– Reduced social engagement
– Avoidance of exercise
– Lost productivity at school/work
When to See a Doctor
You should make an appointment with your doctor if:
– Fatigue regularly affects your quality of life
– You soak through 1 or more pad/tampon per hour
– Your periods last longer than 7 days
– You pass large blood clots
– You experience period-related anemia symptoms like dizziness, pale skin, irregular heart rate
Diagnosis
To diagnose the cause of fatigue from heavy periods, your doctor will:
– Ask about your period symptoms and medical history
– Perform a pelvic exam
– Do a complete blood count test to check hemoglobin, hematocrit, and RBC levels
– Assess your iron levels with blood tests for ferritin, serum iron, and total iron binding capacity
– Check for iron deficiency anemia or other nutritional deficiencies
– Test thyroid function
– Do imaging tests like pelvic ultrasounds/MRIs if fibroids, polyps, or structural issues are suspected
Treatment
Iron Supplements
Oral iron tablets are commonly prescribed to treat iron deficiency anemia from menorrhagia. Taking iron daily helps replenish iron stores and reverses anemia over 1-2 months. This improves oxygen delivery and relieves fatigue.
Hormonal Birth Control
Hormonal IUDs or oral contraceptives may help lighten bleeding by thinning the uterine lining. This reduces blood and iron loss.
NSAIDs
Non-steroidal anti-inflammatories like ibuprofen can minimize bleeding when taken just before and during your period.
Antifibrinolytic Medications
Drugs like tranexamic acid improve blood clotting and decrease menstrual flow.
Endometrial Ablation
This procedure destroys the uterine lining to permanently reduce bleeding. Best for women who don’t want children.
Hysterectomy
Surgically removing the uterus stops all uterine bleeding. Recommended when other treatments fail to resolve menorrhagia and related fatigue.
At-Home Care and Prevention
– Take iron supplements if deficient or anemic
– Eat iron-rich foods like meat, spinach, beans
– Get 8-10 hours of sleep nightly
– Exercise regularly
– Reduce stress through yoga, meditation
– Consider birth control pills or IUDs
– Track your menstrual cycles and symptoms
When to Worry
See your doctor if fatigue:
– Occurs suddenly or severely
– Persists daily
– Is not improved with diet and lifestyle measures
– Is accompanied by shortness of breath, chest pain, dizziness
– Significantly interferes with work, school, or relationships
Otherwise, some degree of fatigue is normal with heavy periods. Be sure to get enough rest, nutrition, and take care of your health during this time.
The Bottom Line
Losing excessive amounts of blood during your period can definitely make you feel run-down and tired. Menorrhagia causes iron deficiency over time, resulting in anemia and chronic fatigue. See your doctor for a full evaluation if you’re regularly so tired that you can’t function normally. Treating the underlying cause of heavy bleeding, whether it’s hormones, fibroids, or other conditions, can help minimize period-related fatigue and improve your energy levels long-term.