How are Ferritin Eisenmangel and menopause related?

The relationship between ferritin, iron deficiency, and menopause is well understood physiologically. Ferritin is the primary iron storage protein. In premenopausal women, monthly menstrual blood loss frequently leads to low ferritin and iron deficiency. With menopause, estrogen declines, menstruation ceases, and iron loss drops dramatically. Consequently, ferritin levels often rise in postmenopausal women, sometimes above the normal range. At the same time, iron overload (hemochromatosis) can become clinically more relevant after menopause because the protective iron loss via menstruation is gone. However, ferritin is also an acute-phase reactant; elevated levels can be driven by inflammation, metabolic syndrome, or liver disease without true iron overload. An isolated low ferritin (<30 µg/L) indicates depleted iron stores even if hemoglobin is still normal. In postmenopause, ferritin deficiency is less common but possible due to gastrointestinal bleeding, malabsorption, or inadequate intake. Clinical practice should always interpret ferritin together with transferrin saturation, CRP, and possibly hemoglobin. DNA testing for HFE mutations (C282Y, H63D) can be useful if hereditary hemochromatosis is suspected, but a genetic test alone does not replace laboratory diagnostics. Evidence: well-established physiology, but individual variation requires medical evaluation.