Exploring the impact of Ramadan fasting on women's reproductive health: A narrative review

Ramadan is the ninth month of the Islamic lunar calendar in which Muslims abstain from consumption of food and drink, smoking, and engaging in sexual activity during daylight hours for the full lunar month, approximately 29-30 days. Beyond its spiritual significance, fasting during this month represents a distinct physiologic and cultural practice that may influence women's reproductive health. This narrative review integrates findings from published studies to summarize current evidence on the impact of Ramadan fasting (RF) on the menstrual cycle, fertility, polycystic ovary syndrome, pregnancy, and breastfeeding. Relevant literature was identified through PubMed and Embase using keywords related to Ramadan and women's health, with emphasis on qualitative synthesis and critical interpretation rather than quantitative comparison. Across the literature, RF appears to cause mild and temporary menstrual irregularities without major hormonal changes. Fertility hormones generally remain stable. Among pregnant and breastfeeding women, most studies report no significant differences in maternal or neonatal health between fasting and non-fasting groups, though findings vary by region, nutritional intake, and gestational timing. While immediate birth outcomes appear largely unaffected, long-term effects have been elucidated through recent studies. Collectively, the evidence highlights the physiologic adaptability of women during RF while revealing the need for more comprehensive research on RF's effect on women's health. Gaining insight into this area of research contributes to a more inclusive and culturally sensitive approach to healthcare, targeting the unique needs of female Muslim patients. This will allow healthcare providers to leverage this research to establish rapport with their patients and deliver attuned, quality care.