Cold, Then Hot, Then Cold Again: Navigating Iron Deficiency and Perimenopause as a Black Woman

Lately, I’ve found myself in a strange and frustrating cycle: one moment I’m freezing cold, the next I’m drenched in a hot flash, then I’m cold again — back and forth like a seesaw I can’t get off. It’s not just annoying for me. My poor 15-year-old daughter has had to deal with my internal thermostat bouncing all over the place. She’ll be hot, and I’m telling her to drink more water. Then she’s cold, and I’m telling her to layer up — all while I’m the one walking around with a hoodie and a fan at the same time.

What I didn’t realize at first is that this wasn’t just aging. I’m currently living through a double storm: iron deficiency and perimenopause. And let me tell you, they don’t play fair. Together, they’ve impacted my energy, my mood, and my daily life. If you're reading this and nodding along, you're not alone — and there are ways to manage it.

Iron Deficiency: The Invisible Energy Thief

Iron deficiency happens when your body doesn’t have enough iron to make healthy red blood cells, which are responsible for carrying oxygen throughout your body. When your cells are literally gasping for air, everything feels harder. Here are some symptoms I’ve personally experienced (and maybe you have too):

Extreme Fatigue and weakness even after a full night’s sleep
Pale skin or a washed-out look
Cold hands and feet, sometimes all day long
Shortness of breath, especially going up stairs
Dizziness or feeling faint when standing too fast
Brittle nails and more hair shedding than usual
Headaches that seem to come out of nowhere
Brain fog — forgetting things mid-sentence or struggling to focus
Restless legs, especially at night
And strangely enough… craving ice. Yes, I’ll admit I’ve crunched on cubes just for the satisfaction.

As a Black woman, I’ve learned that I’m statistically more likely to have iron deficiency, especially because heavier menstrual bleeding is more common among African American women. If you're feeling like something is off, it might not just be “life” — it might be your iron.

Perimenopause: The Sneaky Shift

Then there’s perimenopause, the years leading up to menopause when your hormones start fluctuating — and not in a cute way. These are some of the perimenopausal symptoms I’ve noticed creeping into my life:

Hot flashes and night sweats (the kind that wake you up soaked)
Irregular periods — sometimes heavy, sometimes skipped
Mood swings and irritability (and no, I can’t just “calm down”)
Trouble sleeping — either falling asleep or staying asleep
Memory lapses — walking into a room and forgetting why
Weight gain around my midsection
Heart palpitations and anxiety

These symptoms don’t just affect the body — they affect your confidence, your energy, and how you show up in the world. And for those of us also dealing with iron deficiency, the fatigue and mental fog are next-level.

When Iron Deficiency Meets Perimenopause

Now imagine experiencing both of these at the same time. You might feel:

Utter exhaustion, like dragging yourself through the day
Fluctuating body temperatures, from chills to sweats in seconds
Low mood, anxiety, or depression
Constant confusion — “Did I already take my iron pill today?”
And just a general sense of “something’s not right”

What makes it more complex is that the symptoms overlap, so it’s easy to dismiss them as “normal aging” or “just stress.” But your body might be waving a red flag — and it deserves attention.

What Helped Me (and Might Help You Too)

Here are some things that I’ve found helpful — both for managing my iron deficiency and my perimenopause symptoms:

💊 1. Get Tested

Ask your doctor for a full blood panel — including ferritin, hemoglobin, and iron levels. Don’t assume fatigue is just from age or parenting. You may need a daily iron supplement, and in some cases, IV iron treatments.

🍽 2. Boost Iron Through Food

Iron-rich foods include spinach, lentils, beans, red meat, pumpkin seeds, tofu, and fortified cereals. Pair them with vitamin C-rich foods like oranges or bell peppers to help with absorption.

🚫 3. Avoid Iron Blockers

Avoid drinking coffee, tea, or eating calcium-rich foods (like dairy) near the time you take your iron supplement — they can block absorption. Iron is best absorbed on an empty stomach with something acidic to help it along. I used to take mine with straight orange juice, but that started upsetting my stomach. Now I mix orange juice and apple juice together, which is gentler and still gives me the vitamin C boost I need for absorption.

🧘🏾‍♀️ 4. Track Your Symptoms

Using an app like Clue or a good ol' notebook helped me identify patterns — especially with hot flashes, period changes, and mood swings.

😴 5. Prioritize Sleep and Hydration

Easier said than done, but game-changing when you can manage it. Sleep affects everything from mood to metabolism.

🫂 6. Talk About It

Whether it’s your daughter, your girlfriends, or your doctor — talk it out. Perimenopause and iron deficiency aren’t always openly discussed, especially in our communities. But silence doesn’t help healing.

🧑🏽‍⚕️ 7. Find the Right Doctor

Not all providers are well-versed in perimenopause, especially how it impacts women of color. Find one who listens, believes you, and supports your health holistically.

For My Sisters Going Through This Too

If you're a woman of color juggling fatigue, mood swings, memory loss, and unpredictable body temperatures — you are not alone. This isn’t in your head. You’re not lazy. You’re not overreacting. You’re navigating two intense health experiences at once — and doing the best you can.

Take care of yourself. Ask for help. Say no when you need to. And please, don’t suffer in silence.

We deserve answers. We deserve wellness. And we deserve to feel like ourselves again.

Cold, Then Hot, Then Cold Again: Navigating Iron Deficiency and Perimenopause as a Black Woman