{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:53:39Z","timestamp":1790898819647,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Intermittent fasting (IF) has emerged as a popular dietary intervention with potential metabolic and endocrine benefits. However, its effects on sexual function and reproductive health remain incompletely understood. This comprehensive review synthesizes current evidence from human clinical trials and animal studies examining the impact of various IF protocols\u2014including time-restricted eating (TRE), alternate-day fasting (ADF), and Ramadan fasting\u2014on male and female sexual function, reproductive hormones, and fertility outcomes. In males, limited human data suggest preserved erectile function but reduced sexual desire during Ramadan fasting, with neutral effects on testosterone in obese adults undergoing TRE. Animal studies demonstrate context-dependent effects, with IF protecting against high-fat diet-induced reproductive dysfunction while potentially impairing spermatogenesis under prolonged energy restriction. In females, IF shows promise for improving hyperandrogenism and menstrual regularity in polycystic ovary syndrome (PCOS), mediated by enhanced insulin sensitivity and reduced free androgen index. However, direct measurements of female sexual function domains (libido, arousal, lubrication, orgasm) are largely absent from the literature. Mechanistic pathways involve modulation of the hypothalamic\u2013pituitary\u2013gonadal (HPG) axis, insulin\u2013adipokine signaling, sex hormone-binding globulin (SHBG), and oxidative stress pathways. Evidence quality is limited by small sample sizes, heterogeneous protocols, short follow-up periods, and predominance of animal data. While IF may offer reproductive benefits in metabolically compromised populations, particularly women with PCOS, caution is warranted in young, lean, or energy-deficient individuals. Future research should employ standardized IF protocols, validated sexual function instruments, and long-term fertility endpoints to establish evidence-based clinical recommendations.<\/jats:p>","DOI":"10.3390\/nu18111817","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:11:04Z","timestamp":1780593064000},"page":"1817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Intermittent Fasting on Male and Female Reproductive Hormones, Fertility, and Sexual Function: A Comprehensive Review with Emphasis on the Existing Evidence Gap in Women"],"prefix":"10.3390","volume":"18","author":[{"given":"Sandro","family":"La Vignera","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5217-9343","authenticated-orcid":false,"given":"Rosita A.","family":"Condorelli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.35630\/2025\/15\/4.005","article-title":"Intermittent fasting\u2014Its benefits and risks","volume":"15","author":"Prosowski","year":"2025","journal-title":"Arch. EuroMedica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e70586","DOI":"10.1002\/fsn3.70586","article-title":"Intermittent Fasting and Hormonal Regulation: Pathways to Improved Metabolic Health","volume":"13","author":"Shkorfu","year":"2025","journal-title":"Food Sci. Nutr."},{"key":"ref_3","first-page":"1726","article-title":"Intermittent fasting as a dietary intervention with potential sexually dimorphic health benefits","volume":"82","author":"Macip","year":"2024","journal-title":"Nutr. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/00926230802096234","article-title":"Sexual well-being, happiness, and satisfaction, in women: The case for a new conceptual paradigm","volume":"34","author":"Rosen","year":"2008","journal-title":"J. Sex Marital Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2978","DOI":"10.1001\/jama.291.24.2978","article-title":"Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial","volume":"291","author":"Esposito","year":"2004","journal-title":"JAMA"},{"key":"ref_6","unstructured":"Plant, T.M., and Zeleznik, A.J. (2015). Knobil and Neill\u2019s Physiology of Reproduction, Academic Press. [4th ed.]."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.yhbeh.2014.03.011","article-title":"Our stolen figures: The interface of sexual differentiation, endocrine disruptors, maternal programming, and energy balance","volume":"66","author":"Schneider","year":"2014","journal-title":"Horm. Behav."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"G\u00fcven, A. (2023). Eight-Hour Time-Restricted Feeding: A Strong Candidate Diet Protocol for First-Line Therapy in Polycystic Ovary Syndrome. Nutrients, 15.","DOI":"10.3390\/nu15102260"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kumar, S., and Kaur, G. (2013). Intermittent fasting dietary restriction regimen negatively influences reproduction in young rats: A study of hypothalamo-hypophysial-gonadal axis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0052416"},{"key":"ref_10","first-page":"2078","article-title":"The effect of fasting on erectile function and sexual desire on men in the month of Ramadan","volume":"12","author":"Talib","year":"2015","journal-title":"Urol. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.urology.2020.07.019","article-title":"Organic diet and intermittent fasting are associated with improved erectile function","volume":"144","author":"Huynh","year":"2020","journal-title":"Urology"},{"key":"ref_12","unstructured":"Cienfuegos, S., Corapi, S., Gabel, K., Ezpeleta, M., Kalam, F., Lin, S., Pavlou, V., and Varady, K.A. (2024). Effect of time restricted eating versus daily calorie restriction on sex hormones in males and females with obesity. medRxiv."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cienfuegos, S., Gabel, K., Kalam, F., Ezpeleta, M., and Varady, K.A. (2022). Effect of Intermittent Fasting on Reproductive Hormone Levels in Females and Males: A Review of Human Trials. Nutrients, 14.","DOI":"10.3390\/nu14112343"},{"key":"ref_14","first-page":"277","article-title":"Effect of Ramadan Fasting on Sex Hormones in Infertile Male","volume":"9","year":"2013","journal-title":"Tikrit J. Pharm. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Poursalehian, M., Soltanieh, S., Barzegar, A., Hassanzadeh Keshteli, A., Esmaillzadeh, A., and Adibi, P. (2024). Impact of Ramadan fasting on serum levels of major endocrinology hormonal and biochemical parameters in healthy non-athlete adults: A systematic review and meta-analyses. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0299695"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"RD24187","DOI":"10.1071\/RD24187","article-title":"Intermittent fasting restores fertility dysfunction caused by a high-fat diet in male rats: Role of SIRT-1\/NRF2\/P38 MAPK\/NLRP3","volume":"37","author":"Hemead","year":"2025","journal-title":"Reprod. Fertil. Dev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s44337-025-00289-7","article-title":"Intermittent fasting is beneficial for body weight regulation and reproductive phenotypes in high-fat diet-fed male mice","volume":"2","author":"Buranaamnuay","year":"2025","journal-title":"Discov. Med."},{"key":"ref_18","first-page":"12","article-title":"Evaluation of the Effects of Fasting on Fertility in Adult Male Wistar Rats","volume":"3","author":"Omolaso","year":"2012","journal-title":"IOSR J. Pharm. Biol. Sci."},{"key":"ref_19","first-page":"5562120","article-title":"Exploring the Impact of Ketogenic Diet and Intermittent Fasting on Male Rats\u2019 Testicular Health: An Analysis of Hormonal Regulation, Oxidative Stress, and Spermatogenesis","volume":"2023","author":"Koca","year":"2023","journal-title":"J. Food Biochem."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.crphys.2022.10.001","article-title":"Skipping the first active meal appears to adversely alter reproductive function in female than male rats","volume":"5","author":"Oyelowo","year":"2022","journal-title":"Curr. Res. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.cmet.2025.03.001","article-title":"Intermittent fasting boosts sexual behavior by limiting the central availability of tryptophan and serotonin","volume":"37","author":"Xie","year":"2025","journal-title":"Cell Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e219","DOI":"10.1016\/j.fertnstert.2023.08.218","article-title":"The impact of intermittent fasting on sperm parameters","volume":"120","author":"Sayme","year":"2023","journal-title":"Fertil. Steril."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.12891\/ceog15722014","article-title":"Effects of Long-Term Fasting on Female Hormone Levels: Ramadan Model","volume":"41","author":"Caglayan","year":"2014","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_24","first-page":"2117","article-title":"Effect of time-restricted eating on sex hormone levels in premenopausal and postmenopausal females","volume":"30","author":"Kalam","year":"2022","journal-title":"Obesity"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"16057","DOI":"10.1038\/nrdp.2016.57","article-title":"Polycystic ovary syndrome","volume":"2","author":"Azziz","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100341","DOI":"10.1016\/j.metop.2024.100341","article-title":"The impact of intermittent fasting on fertility: A focus on polycystic ovary syndrome and reproductive outcomes in Women\u2014A systematic review","volume":"25","author":"Velissariou","year":"2025","journal-title":"Metab. Open"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ranneh, Y., Akim, A.M., Hamid, H.A., Khazaai, H., Fadel, A., Zakaria, Z.A., Albujja, M., and Bakar, M.F.A. (2025). Effect of Intermittent Fasting on Anthropometric Measurements, Metabolic Profile, and Hormones in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Nutrients, 17.","DOI":"10.3390\/nu17152436"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.70070\/mrwarz94","article-title":"The analysis study effect of intermittent fasting on female reproductive hormones and menstrual cycle: A comprehensive systematic review","volume":"9","author":"Waly","year":"2025","journal-title":"Int. J. Med. Sci. Health Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100513","DOI":"10.1016\/j.repbio.2021.100513","article-title":"Intermittent fasting ameliorates di-(2-ethylhexyl) phthalate-induced precocious puberty in female rats: A study of the hypothalamic\u2013pituitary\u2013gonadal axis","volume":"21","author":"Yu","year":"2021","journal-title":"Reprod. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e17160607","DOI":"10.1590\/1678-4324-2017160607","article-title":"Effect of Intermittent Feeding on Gonadal Function in Male and Female NMRI Mice During Chronic Stress","volume":"60","author":"Ehteram","year":"2017","journal-title":"Braz. Arch. Biol. Technol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1210\/er.2011-1034","article-title":"Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications","volume":"33","author":"Dunaif","year":"2012","journal-title":"Endocr. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1038\/ncpendmet1003","article-title":"Ghrelin as a pleotrophic modulator of gonadal function and reproduction","volume":"4","year":"2008","journal-title":"Nat. Clin. Pract. Endocrinol. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/1477-7827-10-49","article-title":"The effects of oxidative stress on female reproduction: A review","volume":"10","author":"Agarwal","year":"2012","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1093\/nutrit\/nuaf107","article-title":"Intermittent Fasting in Female Reproduction: A Double-Edged Sword","volume":"84","author":"Yang","year":"2025","journal-title":"Nutr. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Salamy, N., Putri, A.K., and Sari, D.P. (2025). Pengaruh puasa intermiten terhadap kesehatan hormonal dan reproduksi wanita: Tinjauan literatur. J. Penelit. Keperawatan Kontemporer, 5.","DOI":"10.59894\/jpkk.v5i4.989"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1743-6109.2011.02539.x","article-title":"Sexual function in women with polycystic ovary syndrome","volume":"9","author":"Stovall","year":"2012","journal-title":"J. Sex. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1817\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:21:56Z","timestamp":1780719716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["nu18111817"],"URL":"https:\/\/doi.org\/10.3390\/nu18111817","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}