Impact of body iron store on sexual function: a comprehensive review and pilot cohort study in midlife women

Arch Gynecol Obstet. 2019 Aug;300(2):469-480. doi: 10.1007/s00404-019-05206-9. Epub 2019 Jun 6.


Purpose: Both iron deficiency (ID) and female sexual dysfunction (FSD) affect more than 25% of the world population. The aim of this study was to identify a connection between these two conditions based on the existing literature and to investigate this interrelation in a small pilot cross-sectional study.

Methods: A database search for publications referring to ID and FSD was conducted. The resulting common denominators were used to formulate hypotheses regarding the interaction of these diseases. Simultaneously, 45 healthy middle-aged women completed questionnaires about their sexual function and provided a blood sample for the purpose of determining ferritin and haemoglobin levels. The main outcome measures included an analysis of responses to questions on sexuality and partnership and of blood ferritin and haemoglobin levels. The secondary outcomes included an assessment of further influences on libido, such as sex hormones, menopausal status, health, and life satisfaction.

Results: Altered monoaminergic cerebral metabolism, hyperprolactinaemia and hypothyroidism, impaired socioemotional interaction, increased anxiety, and depression in both, ID and FSD, account for the most comprehensive explanations for the postulated association between the two conditions. Despite a feasible assumption, our empirical findings failed to demonstrate any correlation between ID and FSD. We identified a certain impact of menopausal hormonal status on sexual function.

Conclusion: ID has no influence on FSD in the given population, although the literature suggests that FSD may at least be partly due to ID. Further research seems justified given the potential advantages for sexual health, considering that ID is an easily treatable disease.

Keywords: Ferritin; Healthy midlife women; Iron deficiency (anaemia); Libido; Sexual (dys)function.

Publication types

  • Review

MeSH terms

  • Aged
  • Anemia, Iron-Deficiency / complications*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Iron / metabolism*
  • Middle Aged
  • Pilot Projects
  • Sexual Behavior / physiology*
  • Sexual Dysfunction, Physiological / blood*
  • Sexual Dysfunction, Physiological / etiology*
  • Surveys and Questionnaires


  • Iron