Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Communication
  • Published:

Consequences of iron depletion on health in menstruating women


Objective: To examine the consequences of single iron depletion on health in menstruating women, a common but rarely investigated situation in industrialized countries.

Design: We studied data issued from the SU.VI.MAX. cohort via a transversal and a longitudinal (2-y follow-up) approach.

Subjects and methods: Iron-depleted menstruating women (ferritin <15 μg/l, n=472) were compared with iron-sufficient (ferritin 30–80 μg/l, n=393) menstruating women (aged 35–51 y) in terms of health variables and quality of life (DUKE score) using logistic regression and analysis of variance.

Results: The risk of any infection or of specific types of infections was not increased by iron deficiency. Regarding the DUKE health profile, no specific score was significantly different between the two groups: only the scores reflecting ‘physical health’ (P=0.09) and ‘perceived health’ (P=0.12) showed a trend toward a lower level, while the best score for ‘mental health’ (P=0.11) was found in the group of iron-depleted women. The only significant difference between iron-depleted and iron-sufficient women concerned memory disorders, which were significantly less common in iron-depleted women, Odds ratio=0.7 (0.6–0.9; P=0.03).

Conclusions: There is no conclusive evidence that an absence of iron stores has negative consequences; however, we must consider that in the case of a worsening of the iron balance, it may lead to a rapid decrease in the level of functional compounds.

Sponsorship: The laboratory Robapharm, Pierre Fabre, France.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others


  • Al-Younes HM, Rudel T, Brinkmann V, Szczepek AJ & Meyer TF (2001): Low iron availability modulates the course of Chlamydia pneumoniae infection. Cell. Microbiol. 3, 427–437.

    Article  CAS  Google Scholar 

  • Bohbot VD, Allen JJ & Nadel L (2000): Memory deficits characterized by patterns of lesions to the hippocampus and parahippocampal cortex. Ann. N. Y. Acad. Sci. 911, 355–368.

    Article  CAS  Google Scholar 

  • Bouchet C, Guillemin F, Paul-Dauphin A & Briançon S (2000): Selection of quality-of-life measures for a prevention trial: a psychometric analysis. Control. Clin. Trials 21, 30–43.

    Article  CAS  Google Scholar 

  • Centers for Disease Control (CDC) (1998): Recommendations to prevent and control iron deficiency in the United States. MMWR 47, 1–25.

  • Collaborative Group on Hormonal Factors in Breast Cancer (1997): Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52705 women with breast cancer and 108411 women without breast cancer. Lancet 390, 1047–1059.

  • Dallman PR (1987): Iron deficiency and the immune response. Am. J. Clin. Nutr. 46, 329–334.

    Article  CAS  Google Scholar 

  • Erikson KM, Jones BC, Hess EJ, Zhang Q & Beard JL (2001): Iron deficiency decreases dopamine D(1) and D(2) receptors in rat brain. Pharmacol. Biochem. Behav. 69, 409–418.

    Article  CAS  Google Scholar 

  • Fogelholm M, Alopaeus K, Silvennoinen T & Teirila J (1993): Factors affecting iron status in non-pregnant women from urban south Finland. Eur. J. Clin. Nutr. 47, 567–574.

    CAS  PubMed  Google Scholar 

  • Galan P, Yoon HC, Preziosi P, Viteri F, Valeix P, Fieux B, Briançon S, Malvy D, Roussel A-M, Favier A & Hercberg S (1998). Determining factors in the iron status of adult women in the SU.VI.MAX study. Eur. J. Clin. Nutr. 52, 383–388.

    Article  CAS  Google Scholar 

  • Guillemin F, Paul-Dauphin A, Virion JM, Bouchet C & Briançon S (1997): The DUKE health profile: a generic instrument to measure the quality of life tied to health. Santé Publ. 9, 35–44 (in French).

    CAS  Google Scholar 

  • Haas JD & Brownlie IV T (2001): Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J. Nutr. 131(Suppl 2), S676–S690.

    Article  Google Scholar 

  • Hallberg L (1995): Results of surveys to assess iron status in Europe. Nutr. Rev. 53, 314–322.

    Article  CAS  Google Scholar 

  • Hallberg L & Asp NG (1996): Iron Nutrition in Health and Disease, p 364. London: John Libbey.

    Google Scholar 

  • Hallberg L, Hulthen L, Bengtsson C, Lapidus L & Lindstedt G (1995): Iron balance in menstruating women. Eur. J. Clin. Nutr. 49, 200–207.

    CAS  PubMed  Google Scholar 

  • Hallberg L, Hulthen L & Garby L (1998): Iron stores in man in relation to diet and iron requirements. Eur. J. Clin. Nutr. 52, 623–631.

    Article  CAS  Google Scholar 

  • Hallberg L, Hulthen L & Garby L (2000): Iron stores and haemoglobin iron deficits in menstruating women. Calculations based on variations in iron requirements and bioavailability of dietary iron. Eur. J. Clin. Nutr. 54, 650–657.

    Article  CAS  Google Scholar 

  • Hercberg S, Galan P & Dupin H (1990): Recent Knowledge on Iron and Folate Deficiency in the World, p 700. Paris: Editions INSERM.

    Google Scholar 

  • Hercberg S, Preziosi P, Briançon S, Galan P, Triol I, Malvy D, Roussel A-M & Favier A (1998): A primary prevention trial of nutritional doses of antioxidant vitamins and minerals on cardiovascular diseases and cancers in general population: The SU.VI.MAX study. Design, methods and participants characteristics. Control. Clin. Trials 19, 336–351.

    Article  CAS  Google Scholar 

  • Hercberg S, Preziosi P, Galan P, Faure H, Arnaud J, Duport N, Malvy D, Roussel A-M, Briançon S & Favier A (1999): ‘The SU.VI.MAX study’: a primary prevention trial using nutritional doses of antioxidant vitamins and minerals in cardiovascular diseases and cancers. Food Chem. Toxicol. 37, 925–930.

    Article  CAS  Google Scholar 

  • Hercberg S, Preziosi P & Galan P (2001): Iron deficiency in Europe. Public Health Nutr. 4, 537–545.

    Article  CAS  Google Scholar 

  • Hulthen L, Lindstedt G, Lundberg PA & Hallberg L (1998): Effect of a mild infection on serum ferritin concentration—clinical and epidemiological implications. Eur. J. Clin. Nutr. 52, 376–379.

    Article  CAS  Google Scholar 

  • Parkerson Jr GR, Broadhead WE & Tse CK (1991): Development of the 17-item Duke Health Profile. Fam. Pract. 8, 396–401.

    Article  Google Scholar 

  • Prasad AN & Prasad C (1991): Iron deficiency; non-hematological manifestations. Prog. Food Nutr. Sci. 15, 255–283.

    CAS  PubMed  Google Scholar 

  • Sato S (1991): Iron deficiency: structural and microchemical changes in hair, nails, and skin. Semin. Dermatol. 10, 313–319.

    CAS  PubMed  Google Scholar 

  • UNICEF/WHO/UNU/MI (1998): Preventing Iron Deficiency in Women and Children: Technical Consensus on Key Issues and Resources for Programme Advocacy, Planning, and Implementation. New York: UNICEF.

  • Walter T, Olivares M, Pizarro F & Munoz C (1997): Iron, anemia, and infection. Nutr. Rev. 55, 111–124.

    Article  CAS  Google Scholar 

  • Youdim MB, Ben-Shachar D, Ashkenazi R & Yehuda S (1983): Brain iron and dopamine receptor function. Adv. Biochem. Psychopharmacol. 37, 309–321.

    CAS  PubMed  Google Scholar 

  • Youdim MB, Ben-Shachar D & Yehuda S . (1989): Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. Am. J. Clin. Nutr. 50, S607–S617.

    Article  Google Scholar 

  • Youdim MB & Yehuda S (2000): The neurochemical basis of cognitive deficits induced by brain iron deficiency: involvement of dopamine–opiate system. Cell. Mol. Biol. (Noisy-le-grand) 46, 491–500.

    CAS  Google Scholar 

  • Zhu YI & Haas JD (1997): Iron depletion without anemia and physical performance in young women. Am. J. Clin. Nutr. 66, 334–341.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations



Guarantor: S Hercberg.

Contributors: ND did the data statistical analysis and was primarily responsible for writing the manuscript. PP, M-CBR, SB and PG contributed ideas for analysis and editing the paper. AF and JLL carried out ferritin and hemoglobin analyses. SH supervised the whole process.

Corresponding author

Correspondence to S Hercberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duport, N., Preziosi, P., Boutron-Ruault, MC. et al. Consequences of iron depletion on health in menstruating women. Eur J Clin Nutr 57, 1169–1175 (2003).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:



Quick links