This story was originally published by our partners at The Conversation.

Period symptoms are frustrating no matter the time of year. But some women and people with uteruses might feel like certain symptoms are worse during the winter months, when the weather is gloomy, the days are short and cold and flu seems to always be lurking. This phenomenon has even been dubbed “winter period fatigue syndrome”.

Unfortunately, there’s no evidence that such a thing as winter period fatigue syndrome exists. There’s also no good evidence to suggest changes in the seasons can worsen period symptoms. But that doesn’t mean there isn’t a scientific explanation for why you might feel some of your period symptoms are worse during the colder months.

Symptoms such as fatigue, irritability, poor concentration and a weaker immune system may in fact be pointing to the more obvious cause of iron deficiency.

The body needs iron in order to function. Iron helps produce red blood cells, which carry oxygen throughout the body. But many people don’t get enough iron in their diet. In fact, iron deficiency is the most common nutritional deficiency in the world. 

Alongside the symptoms that iron deficiency can cause, low iron can also lead to anaemia — a fall in red blood cell count. While the symptoms of anaemia can be very similar to those caused by iron deficiency (including fatigue, tiredness, and cold hands and feet), symptoms can be more severe, too — leading to heart palpitations, shortness of breath and even loss of consciousness. 

Menstruation is a leading cause of both iron deficiency and anaemia. People with heavy or prolonged periods are particularly at risk as they regularly lose more blood each month than their body can replace. Some studies even estimate that in women who experience heavy periods, 90% are iron deficient and 60% are anaemic.

People who normally have heavy periods might not realise that this could actually be the cause of their fatigue, irritability and difficulty concentrating. This is because so many women who have heavy periods just assume their blood loss is normal. But left unchecked, heavy periods can leave women and people with uteruses trapped in a vicious cycle of progressive blood loss and iron loss, leading to anaemia, which can be difficult to break. 

And even though many clinical guidelines for managing heavy menstrual bleeding recognise the importance of treating iron deficiency and anaemia caused by excessive blood loss, these conditions are still often missed — despite how treatable they are. 

Symptoms In Winter

Many of the symptoms of iron deficiency and anaemia overlap with other health conditions. This is why it’s important to talk to your doctor as soon as symptoms start to make sure you’re getting the right treatment. For example, fatigue, lethargy and changes in mood can also be symptoms of seasonal affective disorder. This is a type of depression that affects some people only in the autumn and winter. 

So if you find your symptoms began when the shorter days and colder weather arrived, exercise, self-care (such as resting if you need to and getting plenty of sleep each night) and a balanced diet that contains plenty of fibre, cards and protein may help somewhat. Your GP may also recommend talking therapy. 

Certain symptoms of iron deficiency may also seem worse during the winter months. Since iron deficiency affects how well your immune system functions, this could explain why you may feel you suffer from more seasonal illnesses during the colder weather. 

But if you find you have such symptoms all year round — and suffer from heavy or prolonged periods — this may be a sign you have iron deficiency. This will require a trip to the GP to be diagnosed, as well as taking an iron replacement if your doctor recommends it. This should significantly improve your quality of life and symptoms. 

While symptoms of tiredness and fatigue brought on by the cold weather should improve when spring arrives, if your symptoms are caused by chronic iron deficiency these will only improve with proper treatment. This is why you should not attribute fatigue, lethargy and poor concentration to the change in season.

Authors:

Jahnavi Daru, specialist registrar in obstetrics and gynaecology, doctoral research fellow, Queen Mary University of London

Ewelina Rogozinska, research fellow in the Meta-Analysis Research Group, UCL

Varsha Jain, clinical research fellow in the MRC Centre for Reproductive Health, University of Edinburgh

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