Sexual dysfunction is prevalent in adult women, negatively affecting their quality of life. It can be caused by various factors including chronic conditions, poor physical or mental health, certain medications, and relationship issues.

Iron deficiency, particularly in women, is a lesser-known risk factor for sexual dysfunction. Iron deficiency can result from factors such as menstruation, pregnancy, abnormal uterine bleeding, nutritional deficiencies, and chronic disease and aging.

In addition to being associated with sexual dysfunction, iron deficiency can cause symptoms like weakness, fatigue, anxiety, depression, and difficulty concentrating. However, the following article explores the relationship between iron deficiency and women’s sexual function, based on the findings of a literature review that was presented at the European Urogynaecological Association Congress in October 2022.

Low iron intake is a significant factor resulting in iron deficiency in vegetarians, vegans, and individuals with eating disorders. Eating disorders often occur at the same time as sexual dysfunction. Though both of these conditions can sometimes be connected to past trauma, bullying, violence, or low self-esteem, they may also be related in part to nutritional deficiencies.

Endurance athletes, despite experiencing amenorrhea (the absence of a menstrual period), may still be at risk for iron deficiency due to restrictive diets, poor iron absorption due to inflammation, and increased iron losses in sweat. While the research on this topic is sparse, some studies suggest that sexual dysfunction is worse in individuals with persistent amenorrhea.

Abnormal uterine bleeding such as heavy menstrual bleeding (menorrhagia) or irregular and heavy periods (metrorrhagia) can also lead to iron deficiency. Menorrhagia affects about 20-30% of premenopausal women and can have a negative impact on their sexual functioning. In fact, a survey in Europe found that 62% of women with menorrhagia reported that their sex life was greatly affected.

During pregnancy, women’s iron needs increase to support a growing baby and increased blood volume. Low iron levels are common at this time. It is vital to monitor and treat low iron during pregnancy, as this condition is linked to risks for both the mother and baby, such as premature birth and cognitive problems.

After childbirth, 25-50% of women may experience postpartum anemia, which can worsen existing sexual problems that are often present after giving birth. Between 41-83% of women have sexual dysfunction in the first few months postpartum, with issues like low sexual desire, difficulty with arousal, difficulty achieving orgasm, and pain during intercourse (dyspareunia).

Iron deficiency can be linked to chronic diseases, inflammation, and obesity, primarily due to increased bodily levels of hepcidin (a hormone that regulates how the body uses iron). Specifically, inflammation and obesity trigger hepcidin production, reducing iron absorption and release, and causing functional iron deficiency. Functional iron deficiency refers to a state in which the body has enough iron, but it is not being utilized properly.

Research on how iron deficiency affects sexual function in people with chronic diseases is limited. However, women with chronic kidney disease, a common cause of iron deficiency, often experience impaired sexual function as well.

Older women may have reduced libido, genital sensitivity, arousal, and lubrication, along with increased pain during sex after menopause. How much these issues are worsened by iron deficiency remains uncertain, and it is important to study what is considered “normal” sexual function in peri- and postmenopausal women and develop tools to identify sexual dysfunction in this age group.

Further research on iron deficiency and how it may contribute to female sexual dysfunction could help clarify future treatment strategies. Fortunately, there is an easy way to increase a person’s iron levels. Taking oral iron supplements has been shown to improve sexual function in women with iron deficiency. If you believe you may have iron deficiency, talk to your health care provider about being tested so you can address the deficiency.

References:

• Serati, M., Espuña-Pons, M., Mouton-Puglisi, A., & Padoa, A. (2023). Iron deficiency and sexual dysfunction in women. Sexual Medicine Reviews, 11(4), 342-348. https://doi.org/10.1093/sxmrev/qead028