There is a particular kind of exhaustion that has become so synonymous with womanhood that we rarely question it. That bone-deep tiredness smoothed over with concealer and caffeine; the creeping brain fog laughed off as “having a moment”; the hum of anxiety blamed on work, children and hormones. We’ve become surprisingly skilled at treating our exhaustion as a given. Rarely do we ask a more fundamental question: what if this isn’t simply the result of modern female life? What if these symptoms are common indicators of a condition that affects roughly one in four women of reproductive age in the UAE – and one that can be identified through a simple blood test and treated relatively quickly? Because you’re probably not just tired – you’re most likely iron deficient.

“While most people associate iron with haemoglobin and oxygen transport, its role extends far beyond preventing anaemia,” says Dr Manar Jabbar Hussein, a specialist in obstetrics and gynaecology at Medcare. “It supports energy levels, immunity, brain function and healthy pregnancy and, without it, metabolism slows and resilience drops.” Symptoms of iron deficiency include persistent fatigue that doesn’t improve with rest, hair thinning, brittle nails, cold intolerance, brain fog and shortness of breath. With Dr Karima Arroud, functional medicine practitioner at Dubai-based holistic medical centre Wellth, adds that, “most women describe afternoon crashes, reduced exercise tolerance or feeling less resilient under stress.”

THE GENDER DIVIDE

In the so-called battle of the sexes, you could argue that women are navigating an uneven battlefield. Sure, we’re expected to live longer – in 2024, global life expectancy at birth was around 76 years for women compared to 71 for men – but longevity doesn’t necessarily mean an easier ride. Between hormonal shifts, reproductive milestones and the invisible mental load so many of us carry, our health concerns are often more complex than they first appear, and too easily dismissed as “just part of being a woman.” Iron deficiency is a perfect example, and it’s far more common than many of us realise. In fact, according to a Global Burden of Disease study led by the Institute for Health Metrics and Evaluation at the University of Washington, iron deficiency anaemia ranks among the top five causes of disability in women of reproductive age worldwide while, in South Asia, it remains one of the region’s most persistent health and equity challenges, affecting nearly half of all adolescent girls and women.

But why are women so disproportionately affected? “The answer is largely biological,” explains Dr Karima. “Women experience regular blood loss through menstruation, and blood contains iron. Even cycles considered normal can gradually deplete iron stores over time. Pregnancy significantly increases iron demand due to blood volume expansion and fetal development, while breastfeeding continues this demand.” And that’s only part of the story, with conditions such as endometriosis and fibroids, which often cause heavy bleeding, further increasing the risk. Even during perimenopause, cycles frequently become heavier before they become irregular, paradoxically raising iron requirements during that transition. “Men simply do not face these recurring physiological demands,” Dr Karima adds.

THE HIDDEN DEFICIT

The tricky thing about iron deficiency is that it exists on a spectrum, quietly depleting stores long before it tips over into fullblown anaemia. Standard blood work may come back ‘normal’, yet still fall short of what your body actually needs to function well, which helps explain why so many women continue to feel exhausted despite being told everything looks fine. “From a functional medicine perspective, a ferritin level below 30 ng/mL indicates depleted stores, but many women begin experiencing symptoms when ferritin drops below 50 ng/mL, even if hemoglobin remains normal,” explains Dr Karima. In other words, by the time anaemia is officially diagnosed, iron depletion has often been simmering in the background for months, sometimes years. “Optimal levels vary individually, but thriving is very different from merely being within range,” she adds. The good news? Once diagnosed, the treatment is usually straightforward, whether through targeted supplementation, dietary adjustments or addressing underlying causes such as heavy bleeding.

REBUILDING YOUR RESERVES

So, what if you discover your iron levels are low? Unlike some nutrients, iron isn’t something the body can manufacture on its own – we’re entirely dependent on what we eat and, crucially, what we actually absorb, to keep our stores where they need to be. Women, unsurprisingly, require more than men too – on average we need to absorb at least three to four milligrams of dietary iron per day, compared to roughly one to two for men. If you experience heavy periods, that can climb to five or six milligrams, while pregnancy raises the bar significantly, with 10 to 12 milligrams considered optimal. It’s a substantial ask, and one that can be even more challenging for women following vegetarian or vegan diets, where iron intake is often lower and found in a form that’s harder for the body to use. “Dietary iron exists in two forms: heme iron, found in animal sources such as red meat and liver; and non-heme iron, found in plant foods like lentils, spinach and legumes,” advises Dr Fatima. “Heme iron is significantly more bioavailable, which makes adequate high-quality protein intake particularly important for menstruating women.”

Then, of course, there are iron supplements, which can be highly effective when appropriately prescribed and properly absorbed. “Forms such as iron bisglycinate tend to be better tolerated than traditional ferrous sulfate, which may cause digestive discomfort,” advises Dr Manar. But supplementation is not always as simple as swallowing a tablet given the fact many women are navigating compromised gut health thanks to chronic stress, low stomach acid, coeliac disease, IBS or repeated courses of antibiotics that disrupt the microbiome. When the integrity of the gut lining is affected, the body may struggle to absorb iron and other key micronutrients such as B vitamins efficiently. In these cases, intravenous iron can be transformative – delivered directly into the bloodstream, it bypasses the digestive tract entirely and can replenish depleted stores far more rapidly. However, as the experts stress, it’s not a shortcut. “IV therapy should not replace investigation. It is important to understand why iron became depleted in the first place and address the underlying cause,” affirms Dr Fatima.

REFUSING TO RUN ON EMPTY

If you suspect your exhaustion runs deeper than a busy schedule, testing is the logical next step. This is particularly important if you are planning a pregnancy, currently pregnant or navigating the postpartum period, when iron demands are at their highest. “From a preventive perspective, I often recommend annual ferritin testing for menstruating women,” advises Dr Fatima. “Early testing allows us to intervene before energy, cognition and hormonal balance are significantly affected.

Iron deficiency is not simply a laboratory value – it is often a reflection of how well a woman’s body is meeting the energetic demands of her life stage.” Perhaps the most empowering takeaway is this: relentless fatigue is not a personality trait, nor is it an inevitable side effect of modern womanhood. Sometimes it is simply your body asking for support – and that is something we can test, treat and, crucially, refuse to normalise.

– For more on luxury lifestyle, news, fashion and beauty follow Emirates Woman on Facebook and Instagram

Images: Supplied