The impacts of climate change on women’s reproductive and sexual health: a systematic review

BACKGROUND: Climate change is considered a substantial threat to women's health, particularly in their reproductive and sexual well-being. Several studies linked to changes in fertility rates, ovarian reserve, menopause timing, maternal and child health outcomes, and reproductive decision-making. While recent studies have suggested a correlation between climate variability and reproductive and sexual health outcomes, a comprehensive synthesis of existing research on this relationship is lacking. AIM: This study systematically reviews the available evidence on the association between climate change and women's reproductive and sexual health. METHODS: A thorough search was conducted across Medline/PubMed, Scopus, Web of Science, and Cochrane Library databases up to May 2024. This review follows a registered protocol with the PROSPERO database (ID: CRD42024575251). Data were extracted using a standardized template, and quality evaluation was carried out using the Joanna Briggs Institute's Critical Appraisal Tools. RESULTS: The search identified 3581 records, from which 12 observational studies were selected following screening. Most included studies were of moderate quality. Exposures were assessed using direct meteorological measures and subjective perceptions of climate change. The findings indicate that high temperatures are significantly associated with adverse outcomes. These include reduced ovarian reserve, lower fertility rates, and diminished reproductive decision-making. Extreme weather events were linked to negative social consequences like forced marriages, while specific regional climates were associated with premature menopause. Concerns about climate change also shape reproductive intentions, as eco-anxiety influences decisions to have smaller families. Conversely, higher latitude correlated with lower fertility rates. CONCLUSION: The review emphasizes the substantial adverse impacts of climate change, whether manifested through winter cold or rising temperatures, on women's reproductive and sexual health. Enhanced public health strategies and more longitudinal studies are needed to establish causality and address women's vulnerabilities in the face of escalating climate impact.