Why Anaemia Is Extremely Common in Indian Women

Why anaemia is common in India

Anaemia is often spoken about casually in India, almost as if it is a “normal” part of a woman’s life. Many women hear lines like “your haemoglobin is a little low” and are sent home with iron tablets—without much explanation. But anemia is not a minor issue. It is a widespread public health problem that silently affects millions of Indian women across all age groups, from teenage girls to elderly women.

India carries one of the highest burdens of anaemia in the world, and women are disproportionately affected. To understand why, we need to look beyond just iron deficiency and explore the social, biological, cultural, and nutritional factors that come together to make anaemia so common among Indian women.

Understanding Anaemia in Simple Terms

Anaemia occurs when the body does not have enough healthy red blood cells or haemoglobin to carry oxygen efficiently. When oxygen delivery drops, every organ in the body is affected. This is why anaemia causes fatigue, breathlessness, dizziness, hair fall, palpitations, poor concentration, and reduced immunity.

In women, anaemia often develops slowly and silently. Because the symptoms are gradual, many women adapt to feeling tired and weak, assuming it is just part of daily life.

1. Menstruation: A Monthly Iron Loss

One of the most important reasons anaemia is common in women is menstruation. Every month, women lose blood—and with it, iron. For women with heavy or prolonged periods, the iron loss is significant.

In many cases:

Heavy bleeding is normalized
Painful or irregular cycles are ignored
Underlying conditions like fibroids or hormonal imbalances go undiagnosed

Without adequate dietary iron to compensate for this monthly loss, iron stores gradually decline, leading to iron-deficiency anaemia.

2. Pregnancy and Repeated Childbirth

Pregnancy places enormous demands on a woman’s body. Iron is needed not just for the mother, but also for the growing fetus and placenta. Blood volume increases during pregnancy, further increasing iron requirements.

In India, many women:

Enter pregnancy already anaemic
Have closely spaced pregnancies
Do not get adequate antenatal nutrition
Stop supplements early due to side effects or poor follow-up

Repeated pregnancies without enough recovery time severely deplete iron and vitamin reserves, making anaemia almost inevitable.

3. Dietary Patterns Low in Absorbable Iron

Indian diets are often rich in carbohydrates but low in high-quality protein and bioavailable iron. While many traditional foods contain iron, much of it is non-heme iron, which is poorly absorbed.

Common dietary issues include:

Low intake of green leafy vegetables
Inadequate consumption of pulses, nuts, seeds, and fruits
Over-reliance on polished rice and refined grains
Skipping meals due to work or household responsibilities

Even when iron is present in the diet, its absorption is affected by other factors.

4. Poor Iron Absorption Due to Tea, Coffee & Gut Health

Iron absorption does not depend only on how much iron you eat—it depends on how well your body absorbs it.

In India:

Tea and coffee are often consumed immediately after meals
Phytates in cereals and legumes block iron absorption
Calcium supplements taken with meals interfere with iron uptake
Gut infections, worms, and chronic inflammation reduce absorption

Vitamin C, which improves iron absorption, is often lacking in daily diets, especially in lower socio-economic settings.

5. Social and Cultural Factors

Anaemia in Indian women is deeply connected to social norms. In many households:

Women eat last
Portion sizes for women are smaller
Nutrient-dense foods are prioritized for children and men
Women ignore their own health due to family responsibilities

Young girls may already be anaemic before marriage. By the time they reach adulthood, years of nutritional neglect have already taken a toll.

6. Teenage Anaemia: The Silent Beginning

Adolescence is a critical period for iron requirements due to rapid growth and the onset of menstruation. Unfortunately, teenage girls are one of the most affected groups.

Reasons include:

Poor dietary diversity
Body image concerns leading to meal skipping
Lack of awareness about nutrition
Increased academic and emotional stress

Anaemia that starts in adolescence often continues into adulthood, pregnancy, and later life if not corrected early.

7. Chronic Infections and Inflammation

Not all anaemia is due to iron deficiency. Chronic infections, inflammatory conditions, and parasitic infestations are common in many parts of India.

Conditions such as:

Recurrent infections
Tuberculosis
Chronic urinary or gastrointestinal infections
Autoimmune conditions

can lead to anaemia of chronic disease, where iron is present in the body but not available for use.

8. Vitamin Deficiencies Beyond Iron

Iron is only one piece of the puzzle. Many Indian women also have deficiencies of:

Vitamin B12
Folate
Vitamin A

Vitamin B12 deficiency is particularly common among vegetarian women and causes a different type of anaemia that does not improve with iron alone. This is why some women do not feel better despite taking iron supplements.