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India continues to face a heavy burden of anaemia, vitamin D deficiency, early bone loss, thyroid disorders, PCOS, and rising cardiometabolic diseases, many of which disproportionately affect women. More than half of Indian women live with anaemia, and vitamin D deficiency affects up to 80–90% of the population. Doctors say these aren’t isolated issues but symptoms of a deeper problem: women’s nutritional needs shift significantly by age, yet most continue eating the same way through their 20s, 30s, 40s and post-menopause.
“A woman’s physiology changes every decade — hormones shift, metabolism slows, and absorption reduces,” says R. K. Vidhya Lakshmi, senior consultant, obstetrics & gynaecology, SRM Global Hospitals, Chennai. These transitions determine which nutrients become crucial and when supplements become essential.
Nutrition by age
Women in their 20s and early 30s are building the foundation for long-term health, and nutrient needs reflect this.
According to Dr. Lakshmi, young women require “more iron and folate, especially when menstruating or pregnant,” along with adequate vitamin B12, particularly if they are vegetarian. She adds that those with limited sun exposure may need vitamin D support earlier than they realise. “A nutritional diet with whole food is always important, but supplements become essential when diet or sun exposure is insufficient,” she says.
R. Sundararaman, senior consultant, internal medicine, SIMS Hospital, Chennai, notes that the 20s and early 30s are often marked by rushed meals. “Protein, calcium and iron are very important at this stage. Many women skip meals or eat in a rush, which leads to low iron and vitamin D.” By the mid-30s, he says, metabolism slows and hormone balance becomes harder to maintain. Good fats, fibre, and portion control help women adjust to this shift. Ankita Dubey, consultant gynecologist, Narayana Hospital, Ahmedabad, adds that younger women frequently present with “haemoglobin deficiency — mostly iron deficiency and vitamin D deficiency” because of heavy menstrual bleeding and limited sunlight due to work schedules.
As women enter their 40s, absorption of certain nutrients declines sharply. Dr. Lakshmi explains that this is when calcium and vitamin D deficiency become prominent. “Women in their 40s and nearing menopause face calcium and vitamin D deficiencies; B12 absorption declines and iron needs drop as menstruation stops,” she says. Dr. Sundararaman observes a predictable pattern: “By the time women reach their 40s, calcium and magnesium levels tend to drop, and vitamin D continues to stay low. Protein and B12 deficiency also become more frequent as appetite and absorption reduce.”
Dr. Dubey notes that in older women calcium deficiency is very common, while iron deficiency becomes less frequent because “bleeding stops after menopause.”
Core nutrient needs
Doctors highlight the same four nutrients as critical during menopause: calcium, vitamin D, vitamin B12, and (to a lesser extent) iron. “Oestrogen levels decline, intensifying intensify bone loss,” says Dr. Lakshmi. Vitamin D becomes just as important: “Calcium gets absorbed into the body via vitamin D, which helps muscle function and strengthens the bone.”
Dr. Sundararaman adds, “During these years, calcium and vitamin D are absolutely vital for bone protection. The fall in oestrogen makes bones thinner and weaker.”
Dr. Dubey notes that due to oestrogen deficiency, “calcium is not absorbed, vitamin D levels fall, and B12 deficiency becomes very common.” Dr. Sundararaman emphasises that after periods stop, “iron needs actually come down,” but vitamins such as B12 and folate become crucial for energy, nerve health and mood.
B12 deficiency is particularly common in vegetarians or older women with reduced absorption. Omega-3 and magnesium, Dr. Sundararaman says, help “improve sleep quality and reduce hot flashes.”
How to choose supplements
Doctors reject the one-size-fits-all approach and emphasis personalisation. The approach should be personalised, they say, and women should get assessed for diet, lifestyle, sun exposure and other risk factors like menopause, heavy menstruation or malabsorption.
Experts also highlight the importance of routine blood tests and clinical indications, when there is suspicion of a deficiency.
Dr. Sundararaman adds that while blood tests aren’t compulsory for everyone, “they help avoid unnecessary tablets. Paying attention to how your body feels is equally important.”
Dr. Dubey says,“This decision should always be based on the guidance of your consultant, who will look at your symptoms and decide by doing blood tests.”
Expert add that in some postmenopausal women, hormone therapy may be required instead of just multivitamins.
Know your needs
Dr. Lakshmi explains that “Vitamins A, D, E and K store in the body and may pose a risk if in excess.” Dr. Sundararaman points out that “more does not mean better,” especially when women unknowingly take overlapping supplements such as a multivitamins plus a hair supplement plus collagen — all containing vitamin D or B12.
Calcium or iron in excess, Dr. Lakshmi says, “may harm kidneys, accelerate cardiovascular disease and may interfere with other nutrients.” Dr. Dubey adds that over-supplementation at the wrong age can bring complications. “High doses or long duration can cause problems with fat-soluble vitamins and minerals, including weight gain,” she says.
Specialists stress that supplements must be used only when medically indicated. Stick to correct doses , review supplements regularly and maintain a nutrient-rich whole-food diet, they say, underscoring that whole foods ensure a broader nutrient matrix that supplements cannot replace.
Published – December 27, 2025 11:04 am IST