When you consider taking a new supplement or medication, it's important to weigh the benefits with the potential side effects. Iron pills are infamous for causing unpleasant side effects such as constipation and general stomach upset. And, when a nutrient is intended to affect your blood health, you may also wonder how it could impact your menstrual cycle. 

Often, people with heavy menstrual cycles will be directed towards iron pills, and this can bring up some important questions: Why do I need to take iron? Can it reduce the heavy bleeding? Is it possible to get the benefits without the side effects?

Let’s dig into it…

Why might you need to take iron?

Iron deficiency (ID) is quite common, affecting 10 million people in the United States. Iron deficiency anemia (IDA), when iron levels are low enough to affect the body’s ability to create red blood cells, affects another 5 million people. 

Iron deficiency, whether with or without anemia, can lead to extreme fatigue, shortness of breath, irregular heartbeats, headaches, and digestive issues. 

Blood contains a protein called hemoglobin, and this protein is responsible for distributing oxygen throughout the body. When iron levels are low, hemoglobin levels lower, making it harder for oxygen to get where it needs to go! It makes sense, then, that we experience the same symptoms that you might experience at a high altitude where oxygen is less readily available. 

Symptoms from iron deficiency may be quite subtle at the beginning but eventually can take quite a toll on one’s quality of life.

How do you become iron deficient?

If you suspect you may be iron deficient, It's important to try to figure out the “why” behind your symptoms so that you can choose the right course of treatment with the help of your healthcare provider. There are several different potential causes of iron deficiency


It’s possible to be iron deficient simply because you’re not consuming enough iron in your diet. If this is the case, the good news is that you don’t have to track down a more elusive or complex root cause. However, the solution to lack of dietary iron isn’t always as straightforward as “eat more iron.” 

Here are some things you should know:

There are actually two different kinds of iron. Heme iron is found in meats, poultry, and seafood, and is much more easily absorbed by our bodies. Non-heme iron is found in legumes, nuts, seeds, and greens, and is harder for the body to access. You can support your body’s ability to absorb non-heme iron by consuming Vitamin C (citrus, bell peppers, broccoli) during the same meal. This is particularly necessary information for vegetarians, who do not have opportunities to get the more readily available heme iron through diet. 

Even with a thoughtful diet, if you are deficient in iron, supplementation will likely be a part of your process of raising iron levels, especially if you are experiencing symptoms that affect your quality of life.

Blood loss

Events such as childbirth, surgeries, or injuries can all result in significant blood loss which may leave you with lower-than-usual iron levels. Typically, if you had healthy levels before one of these events, you can restore your iron levels in a few weeks by taking iron supplements. 

Other medical conditions

Because blood has some real “main character” energy in the menstrual cycle, it makes sense that people struggling with menstrual conditions such as endometriosis, PCOS, fibroids, or heavy bleeding may struggle with maintaining healthy iron and hemoglobin levels. The regular loss of too much blood during menstruation can, over time, result in iron deficiency. 

In addition to some women’s health conditions that cause heavy bleeding, other conditions such as Celiac Disease, Crohn's, Irritable Bowel Syndrome, and various forms of cancer can contribute to an inability to properly absorb iron. 

Pregnant women also sometimes need to supplement iron because their blood volume is adjusting so rapidly to support a growing fetus, impacting overall iron levels

So, will taking iron affect my menstrual cycle?

Supplementation of iron is often recommended for women with heavy bleeding during their menstrual cycle. The question becomes: which came first, the heavy bleeding or the iron deficiency? Can taking iron have an impact on your menstrual cycle?

Iron deficiency is not the cause of heavy bleeding. Heavy bleeding during menstruation likely has another root cause such as endometriosis, PCOS, or fibroids. Therefore, you will probably not notice a direct change in the heaviness of your flow because of iron supplementation. When iron pills are recommended for women with heavy periods, it is because the loss of excess blood over time has resulted in low iron levels. 

However, if you’re looking for relief from symptoms related to your menstrual cycle, there is some good news. Because iron and the health of your blood have such an impact on your overall well-being, and your menstrual cycle is a reflection of your general health (Did you know The American College of Obstetricians and Gynecologists refer to the menstrual cycle as a vital sign?), you may notice an easing of symptoms when you start to increase your iron intake, simply because oxygen is getting appropriately distributed throughout the body, helping to improve overall functionality.

So, while iron supplementation alone may not be the answer to heavy bleeding during the menstrual cycle, it can be an important piece of your whole wellness puzzle. 

Taking an iron supplement

Traditionally, iron pills can be hard on the stomach, causing many women to abandon them even if they really do need to take them! This is especially true for pregnant women who may already be dealing with constipation or other uncomfortable digestive symptoms. 

ACCRUFeR is an iron medication that aims to provide the benefits of increasing iron levels while being gentle on the digestive tract. The iron in ACCRUFeR is protected with a maltol sugar derivative complex which keeps it from breaking down in the stomach. 

It's important to give your body the nutrients it needs, especially if you are recovering from surgery, birth, pregnancy, or injury. The tricky thing with iron is that it is a “long-game” nutrient. You will notice improvement over several weeks or months, meaning that the short-term gratification pales in comparison to the acute side effects of traditional iron pills. That’s why finding an iron medication that doesn’t cause side effects can be such a game changer in sticking with a protocol! 

Key takeaways

If you’re looking into taking iron to deal with heavy bleeding or an uncomfortable menstrual cycle, here’s what you need to know:

  • Iron pills won’t resolve the root cause, but they will probably make you feel better if you have iron deficiency

  • Diet plays an important role but you may need supplemental iron to address symptoms in a timely manner

  • ACCRUFeR allows you to have increased energy, fewer headaches, and a normal heart rate WITHOUT the constipation and digestive discomfort

Johanna Modak is a writer specializing in women's health, nutrition, femtech, and women's sports.