Improving Female Health at Various Life Stages: A systematic review of the impact of date fruit products

Summary

This systematic review examines the effects of date fruit products on female health across different life stages. The quality of the included studies was assessed using the risk of bias tool. A total of 21 eligible studies were reviewed, demonstrating that date fruit consumption benefits puberty, reproductive health, and menopause. During puberty, date fruit intake was associated with improved hemoglobin levels in adolescent girls. In reproductive-age women, date fruits positively influenced fertility parameters and sexual function. Additionally, in menopause, they contributed to alleviating dyspareunia and supporting ovarian reserve maintenance. Providing women with proper nutrition and integrating date fruits into their diet may serve as a cost-effective preventive approach, reducing reliance on medical interventions. Simple dietary recommendations can enhance women's quality of life and support overall well-being.

1. Introduction

The date palm (Phoenix dactylifera L.) is one of the oldest cultivated fruit-bearing trees in the Arabian Peninsula, as well as in parts of the Middle East and arid regions of North Africa.¹ Although its exact origin remains uncertain, historical evidence suggests it may have originated near present-day Iraq.² The date palm holds significant cultural and economic value, serving as both a staple food and a primary source of income for local populations.

Beyond its economic and cultural importance, date fruits are nutritionally rich, providing essential vitamins, minerals and a high caloric content.³ They have been shown to enhance brain function, regulate blood sugar levels and support overall metabolic health. Due to their phosphorus content, date fruits have been associated with increased sexual activity.⁴ Additionally, they contribute to immune function, thyroid support and blood acidity regulation.⁵ Their high iron concentration makes them a valuable dietary component for managing anaemia.⁶ Furthermore, date fruits provide energy, facilitate digestion and support nervous system function due to their rich content of phosphorus, iron, calcium, potassium, magnesium and sodium.⁷ Date fruits also play a role in women's health, particularly in pregnancy and postpartum recovery. They promote uterine involution and reduce postpartum haemorrhage. The presence of oxytocin in date fruits has been linked to facilitating childbirth and regulating uterine contractions during labour.⁸

Biological and gender-related differences significantly influence health outcomes, with female health presenting unique challenges across different life stages.⁹ Throughout these phases, hormonal and physiological changes contribute to various health concerns.¹⁰ For instance, iron deficiency anaemia has been linked to delayed menarche, excessive menstrual bleeding in adolescents, and impaired cognitive function.^11,12 Additionally, women of reproductive age may experience infertility, sexual dysfunction, and other health conditions that affect overall well-being.¹³ The transition to menopause also introduces distinct physiological effects that impact health.¹⁴

Due to its accessibility and high nutritional value, Phoenix dactylifera L. has been recognized for its role in promoting women's health and addressing these concerns.¹⁵ Nutritional intake plays a crucial role in maintaining well-being, as adequate nutrition supports hemoglobin levels during puberty, enhances fertility, and improves sexual function across life stages.^16,17,18,19 Complementary and alternative medicine approaches, including nutritional interventions, are often considered safer than pharmacological treatments for improving fertility, childbirth, and postpartum recovery.²⁰

Given the close relationship between nutrition and health, incorporating nutrient-dense foods into the diet may help women manage various health challenges at different life stages.²¹ While most studies on date fruit consumption have focused on pregnancy and breastfeeding, findings indicate that regular intake improves natural vaginal delivery outcomes and reduces caesarean section rates.^22,23 Despite these known benefits, a comprehensive evaluation of the effects of date fruits across different stages of female life is lacking. Since prior literature reviews have primarily examined their impact on pregnancy and childbirth,⁸ the present study aims to systematically review the effects of date fruit products on female health throughout various life stages.

2. Methods

2.1. Design and registration

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.²⁴

2.2. Search strategy

The databases used included Web of Sciences (WoS), PubMed, Scopus, ProQuest, and Google Scholar were searched to find relevant studies. The search strategy utilised Medical Subject Headings (MeSH) and keyword variations, including: “Puberty”, OR “Puberties”, OR “Adolescents”, OR “Adolescence”, OR “Teenager”, OR “Teenagers”, OR “Teen”, OR “Teens”, OR “Youth”, OR “Youths”, OR “Reproduction”, OR “Reproductive Period”, OR “Period, Reproductive”, OR “Periods, Reproductive”, OR “Reproductive Periods”, OR “Menopause”, “Menopausal”, OR “Menopausal Period”, OR “Period, Menopausal”, OR “Postmenopause”, OR “Postmenopausal Period”, OR “Perimenopause”, OR “Premenopausal Period”, OR “Change of Life, Female”, AND “Phoenix dactylifera”, OR “Date Palm Trees”, OR “Date Palm Tree”, OR “Palm Tree, Date”, OR “Palm Trees, Date”, OR “Tree, Date Palm”, OR “Trees, Date Palm”, OR “Date Palms”, OR “Date Palm”, OR “Palm, Date”, OR “Palms, Date”, OR “Dates, Palm”, OR “Date, Palm”, OR “Palm Date”, OR “Date Palm Fruit”, OR “Date Palm Fruits”, OR “Fruit, Date Palm”, OR “Fruits, Date Palm”, OR “Palm Fruit, Date”, OR “Palm Fruits, Date”, OR “Date Fruit”, OR “Date Fruits”, OR “Fruit, Date”, OR “Fruits, Date”, OR “Palm Dates”, AND “Female”, OR “Females”.

Initially, individual keywords were searched separately, followed by the combination of terms using Boolean operators (“AND” and “OR”) to refine the search results. The review included studies published between January 2013 and March 2024.

2.3. Eligibility criteria

The study selection followed the PICO framework. Participants included females at different life stages, namely puberty, reproductive age, and menopause. The intervention involved the consumption of date fruit products, while comparisons included placebo, routine interventions, or no intervention. Outcome measures assessed puberty-related factors such as anemia, puberty onset, and sexual maturity; reproductive health concerns, including sexual dysfunction, infertility, polycystic ovary syndrome (PCOS), menstrual irregularities, and hormonal parameters; and menopausal issues, such as sexual disorders and ovarian reserve parameters. Only experimental studies were included.

2.4. Study selection

Two independent reviewers (FAR and ESH) conducted the study selection process. Initially, they screened titles and abstracts based on the PICO criteria. Disagreements were resolved through discussion or by consulting a third reviewer. Full-text evaluations were performed on potentially relevant articles using the predefined eligibility criteria. If study details were unclear, the authors of the respective publications were contacted directly. The study selection process is illustrated in Fig. 1.

Fig. 1.

Study flowchart.

2.5. Data extraction

The two reviewers independently extracted data and assessed study quality before resolving any discrepancies through discussion. Extracted information included study characteristics (author, year, study design, region, sample size), participant details (sex, life stage, age in months or years, assessed parameters), trial information (intervention type, control group, study duration, type of date product used), and study outcomes. The extracted data are presented in Table 1.

Table 1.

Details of included studies.^{1,11,17-19,26-41}

Study details				Participants Characteristics				Trial Details
Ref	Study Design	Region	Sample Size	Species	Stage	Age in years	Parameters	Intervention	Control	Period	Date Product	Outcome Results
Al-Abbasi and Al-Wazeer26 (2023)	RCT	Iraq	10	Crossbred heifers	Puberty	6 mth	-LH -FSH -E	2kg DPP+ main ration	main ration	24 wks	Date fruit	Sig for FSH & E(sexual maturity)
Hammod and Hatif28 (2019)	CT	Iraq	10	Crossbred heifers	Puberty	5 mth	Puberty age	20% date supplement/ Daily	Control	∼40 wks	Phoenix dactylifera	In intervention group puberty at 7.8+1.5 mth, & in controls at 11.4+1.2 mth
Alabbasi and Hatif27 (2019)	CT	Iraq	15	Crossbreed heifers	Puberty	5 mth	Puberty age	2kg/daily	main ration	8 wks	Date fruit	7.8 & 9.8 mth Vs. 11.4 & 16.2 mth
Armi and Felina29 (2024)	RCT	Indonesia	30	female adolescent	Puberty	NR	Hb level	3 date fruits /daily	Without intervention	4 wks	Date fruit	Sig increased(m 11.8 g/dL to 13.2 g/dL)
Aulia et al.30 (2022)	quasi-experimental	Indonesia	50	female adolescent	Puberty	12–14	Hb level	NR	NR	NR	Date fruit	Giving dates affects increasing hemoglobin levels in young women
Fathimah et al.1 (2022)	pre-experimental	Indonesia	30	female adolescent	Puberty	15–18	Hb level	7 date fruits/ daily	-	1 wk	Date fruit	10.8±0.79 Vs. 11.9±1.5 g/dL
Wati and Hasibuan32 (2021)	quasi-experimental	Indonesia	13	female adolescent	Puberty	10–19	Hb level	15cc Date juice/daily	250 cc green bean extract/ BD	1 wk	Dates palm juice	Hb levels above 12gr/ dl after being given date palm juice increased to 46.1%
Husnah et al.11 (2021)	RCT	Indonesia	42	female adolescent	Puberty	13–15	Ferritin level	G1: Fe 60 mg supplements twice in a week and every day during menstruation G2: Sukkari dates 50 grams daily in combination with Fe 60 mg supplements twice in a week and every day during menstruation	Without intervention	4 wks	Sukkari dates fruites	G1: 8.38 +3.41 Vs. 33.00 + 17.12 G2:5.00 +1.31 Vs. 34.45 + 10.06
Ali and Alam31 (2020)	pre-experimental	Indonesia	35	female adolescent	Puberty	15–18	Hb level	10 date fruite/daily	-	NR	Ajwa date fruit	10.786 g/dl Vs. s 11.143 g/dl
Irandegani et al.17 (2019)	Quasi-experimental	Iran	31	female adolescent	Puberty	5–11	-Hb level -Hct level	7 dates(100 g)/daily	-	8 wks	Mazafati date fruit	Hgb: 11.19 ± 0.38 Vs. 12.05 ± 0.81 g/dL
							-Ferritin level					-Hct: 34.24 ± 0.41% Vs.37.17 ±2.36%,
												-Ferritin: 47.07 ± 21.89 μg/dL Vs.53.98 ± 19.77 μg/dL
Baagar et al.35 (2022)	RCT	Egypt	60	Rabbit	Reproduction	6 mth	-Reproductive   efficiency -Parameters of   blood -Ovarian   activity -Reproductive   hormonal   profiles	Oral dose of DPP dissolved in 2 ml distilled water at levels of 250 and 500mg per animal	2 ml oral dose of distilled water	5 wks	DPP	-Improvement of   estrogen,   progesterone and   prolactin. -Increased ovulation   and embryo quality   and quality. -Improving the   reproductive   efficiency, and   hematological and   metabolite   parameters.
Rasekhjahromi et al.33 (2022)	RCT	Iran	128	infertile women	Reproduction	27.37±6.86	-Number of   follicles -Follicle size -Endometrial   thickness -FSH -LH	letrozole + tamoxifen + palm pollen(500 mg capsules 3 times/daily/ from the third day of menstruation)	letrozole + tamoxifen	12 wks	DPP extract capsule	Sig increased in both control and intervention groups. But these increases were greater in the control group.
Rasekhjahromi et al.36 (2022)	RCT	Iran	128	Infertile couples	Reproduction	15-49	-FSFI -International   Index of   Erectile   Function	300 mg /daily	Placebo	4 wks	DPP extract capsule	Sig increase
Salmani et al.37 (2022)	RCT	Iran	68	Non-menopausal women	Reproduction	37.24 ± 4.92	-Sexual disorder(FSFI)	300 mg /daily	Placebo	5 wks	DPP extract capsule	DPP supplementation significant increase in desire, lubrication, and the overall score
El-Wahed et al.38 (2022)	CT	Egypt	50	PCOS+ women	Reproduction	20.90±2.22	-FSH -LH -E	3 gr DPP /daily/	-	12 wks	DPP	-FSH(mIU/ml) before Vs. After: 4.69±0.44 Vs. 5.35±1.21 Sig
							-P					-LH(mIU/ml) before Vs. After: 9.13± 2.28 Vs. 4.52± 0.51 Sig
												-E(pg/ml) before Vs. after: 59.02± 12.38 Vs. 29.10± 5.07 Sig
												-P (ng/ml) before Vs. after: 6.26± 1.83 Vs. 12.73± 1.80 Sig
Al-Sayyed et al.39 (2018)	CT	Jordan	37	Menses of women	Reproduction	20–30	-Menses length -Menstrual   cycle length	7 date fruit/daily	Without intervention	4 menstrual cycle	Bahri date fruit	-NS for Menses length(days): 6.43±0.24 Vs. 5.97±0.27
												-NS for Menstrual cycle length(days): 26.11±1.44 Vs. 24.83±1.59
Moshfegh et al.18 (2015)	CT	Iran	10	Fertility of Balb/C mice	Reproduction	NR	- Histological parameter of offspring ovaries	100 and 200 mg/kg/daily	Without intervention	10 days /during gestation / until 21th day after birth	DPP	DPP can create an appropriate situation for oogenesis and maintain efficient fertility in female mice.
Hammed et al.34 (2013)	RCT	Iraq	40	Ovary function and fertility in adult female rats	Reproduction	NR	-LH -FSH	150 mg / kg .B.W. DPP	1 ml distal water	6 wks	DPP	DPP has an obvious improvement effect on fertility hormones
Kurniawan40 (2023)	RCT	Indonesia	44	perimenopausal woman	Menopause	42–48	AMH	60–80 g/7 dates/daily	Without intervention	8 wks	Ajwa date fruit	Less reduction in AMH (y 0.37±0.36 Vs.0.55±0.19 ng/mL)
Loripoor et al.41 (2023)	RCT	Iran	110	Postmenopausal women	Menopause	40–65	-Sexual disorder (FSFI)	300 mg /daily	Placebo	4 wks	DPP extract capsule	NS
Sadeghi et al.19 (2018)	RCT	Iran	60	Postmenopausal women	Menopause	40–65	-Vaginal   lubrication -Dyspareunia	300 mg/ daily	Placebo	5 wks	DPP extract capsule	Sig

RCT = randomized control trial, CT = clinical trial, G = group, mth = month, wk = week, DPP = date palm pollen, LH = Luteinizing hormone, FSH = follicle-stimulating hormone, T = testosterone, P = progesterone, E = estrogen, Sig = significant, NS = not significant, CS = cross-sectional, FSHR = follicle-stimulating hormone receptor, Hb = haemoglobin, BD = twice a day, AMH = anti-Mullerian hormone, NR = not reported, PCOs = polycystic ovarian syndrome, FSFI = Female Sexual Function Index.

2.6. Quality assessment

The risk of bias (RoB) was evaluated using the Cochrane RoB 2 tool, following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions.²⁵ This tool assesses five domains contributing to the overall risk of bias. The second domain, which examines deviations from the intended intervention, was specifically assessed to determine the effect of assignment to the intervention. Each study was categorized as having either “Low RoB,” “Some Concerns,” or “High RoB.” Two reviewers independently conducted the assessments, resolving any discrepancies through discussion. The results of the RoB assessment are summarized in Table 2.

Table 2.

Risk of bias assessment summary. Authors’ judgments about each risk of bias domain for each included study.

Domain
Ref	Randomization Process	Deviation from the intended interventions	Missing outcome data	Measurement of the outcome	Selection ofs the reported results
Al-Abbasi, 202326	+	+	+	+	+
Hammod, 201928	+	+	+	+	+
Alabbasi, 201927	+	+	+	+	+
Armi, 202429	+	?	+	+	+
Aulia, 202230	+	?	+	-	+
Fathimah, 20221	-	+	+	+	+
Wati, 202132	?	+	+	+	+
Husnah, 202111	+	+	+	+	+
Ali, 202031	-	+	+	?	+
Irandegani, 201917	-	+	+	+	+
Baagar, 202235	+	+	+	+	+
Rasekhjahromi, 202233	+	+	+	+	+
Rasekhjahromi, 202236	+	+	+	+	+
Salmani, 202237	+	+	+	+	+
El-Wahed, 202238	-	+	+	+	+
Al-Sayyed, 201839	?	+	+	+	+
Moshfegh, 201518	?	+	+	+	+
Hammed, 201334	+	+	+	+	+
Kurniawan, 202340	+	+	+	+	+
Loripoor, 202341	+	+	+	+	+
sadeghi, 201819	+	+	+	+	+

‘+’ = Low risk; ‘ - ’ = high risk; ‘?’ = some concerns.

3. Results

3.1. Studies description

Following a comprehensive review, 21 studies were included in the final selection, categorized by life stage as follows: puberty (n = 10), reproduction (n = 9), and menopause (n = 3).^{1,11,17,18,19,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41} These studies involved a total of 1,001 participants, comprising 856 women, 35 crossbreed heifers, 10 mice, 40 rats, and 60 rabbits. The selected studies were conducted in various countries, including Iran (n = 7), Indonesia (n = 7), Iraq (n = 4), Egypt (n = 2), and Jordan (n = 1). The study designs included randomized clinical trials (n = 11), clinical trials (n = 5), quasi-experimental studies (n = 3), and peri-experimental studies (n = 2). The study selection process is illustrated in Fig. 1.

3.2. Puberty stages

Three experimental studies assessed the effects of date fruit on luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estrogen levels during puberty, as well as on the sexual maturity of crossbreed heifers. The results indicated that supplementing the animals’ diet with two kilograms of date fruit daily had a positive impact on these hormonal parameters.^26,27,28

Additionally, seven studies investigated the effects of date fruit consumption^{1,11,17,29,30,31} or date fruit juice³² on adolescent females who were anaemic or at risk of anaemia due to puberty and menstruation. Findings suggest that consuming seven date fruits or 250 cc of date syrup daily for durations ranging from seven days to two months improved anaemia-related biomarkers, including haemoglobin, ferritin, and haematocrit levels. These results indicate that regular date fruit intake may help prevent anaemia in adolescent girls.

3.3. Reproductive stages

Fertility: The administration of 500 mg date fruit extract capsules three times daily, alongside tamoxifen and letrozole (standard infertility treatments), for 12 weeks resulted in significant improvements in follicular parameters, endometrial thickness, and LH levels compared to standard treatment alone. However, FSH levels did not show a significant change.³³ Further studies demonstrated that date fruit intake positively influenced ovarian histology in female mice offspring18 and improved ovarian function in rats.^18,34 Another study on rabbits found that oral administration of date palm pollen (DPP) enhanced reproductive efficiency by regulating hematological and metabolic parameters, reducing lipid profiles and oxidative stress, increasing antioxidant capacity and immunity, and improving ovarian activity and embryo quality.³⁵

Sexual Function: The sexual function of infertile couples and the Female Sexual Function Index (FSFI) scores for women—specifically in the domains of desire, lubrication, and overall score—were improved with the daily intake of a 300 mg date extract capsule for 4–5 weeks.^36,37

PCOs: In women with PCOS, the daily consumption of 3 grams of date fruit resulted in enhanced hormonal profiles, including estrogen, progesterone, FSH, and LH levels.³⁸

Menstrual cycle: Daily consumption of seven date fruits had no significant effect on the length of the menstrual cycle or the duration of menstruation.³⁹

The findings from studies conducted during the reproductive phase suggest that the intake of specific quantities of date fruits can positively influence various parameters, such as hormonal balance, ovulation enhancement, metabolic health, and sexual function. These effects were observed in both women (improvements in FSFI) and men (improvements in erectile function).

3.4. Menopausal stages

Three studies examined the effects of date fruit or capsules containing date extract on menopausal symptoms. The findings revealed that consuming seven dates daily for 8 weeks resulted in a decrease in anti-Mullerian hormone (AMH) levels during menopause.⁴⁰ However, the impact of 300 mg date extract capsules on sexual disorders during this phase yielded conflicting results. While a 5-week consumption period showed positive effects on vaginal lubrication and dyspareunia, a 4-week period did not demonstrate significant changes.^19,41

Date fruit consumption during the menopausal period has been associated with improved vaginal lubrication, reduced dyspareunia, and better maintenance of ovarian reserves, as indicated by a smaller reduction in AMH levels.

4. Discussion

This study reviewed the existing literature to assess the impact of date fruit products on female health across different life stages. The findings indicate that date fruits have beneficial effects on puberty, reproduction, and menopause. During puberty, date fruit consumption has been shown to improve haemoglobin levels in adolescent girls. In the reproductive stage, date fruits positively influence fertility by enhancing ovulation and improving hormonal and metabolic parameters, ovarian function, and sexual function, including improvements in the Female Sexual Function Index (FSFI) and erectile dysfunction. Additionally, in menopausal women, date fruit consumption leads to improvements in common sexual disorders, notably better vaginal lubrication.

Micronutrient deficiencies, especially iron and calcium, are prevalent in women, primarily due to insufficient dietary intake, nutrient depletion caused by poor diets, infections, and blood loss during menstruation.⁴² In response, the World Health Organization (WHO) and the United Nations Food and Agriculture Organization (FAO) have adopted four key strategies to improve dietary intake: food fortification, micronutrient supplementation, nutrition education, and disease control interventions.⁴³

Date fruits are rich in iron and calcium, both essential for blood formation and bone marrow function. Iron plays a crucial role in haemoglobin production in the bone marrow and is transported to body tissues where it is needed.⁴⁴ The high iron content of date fruits helps meet the increased iron demands during adolescence and compensates for iron lost through menstruation.⁴⁵ The relationship between iron and haemoglobin levels can be explained by the role of iron in blood synthesis, specifically in haemoglobin formation.⁴⁶ Adequate iron stores are necessary to maintain consistent blood cell production in the bone marrow. Regular consumption of date fruits, which are rich in iron, ensures that the body's needs for hemopoiesis are met.⁴⁷ Research on the impact of date fruit consumption on anaemia-related indicators has shown significant improvements. In particular, adolescent girls consuming date fruits have demonstrated notable increases in haemoglobin levels.^17,30

Date fruits contain steroidal compounds such as estradiol, estrone, estriol, and triterpenes, which serve as structural precursors, including α-amyrin and immature gonadotropic structures.⁴⁸ Additionally, extracts of date fruits contain a non-crystalline estrogenic component.⁴⁹ Moreover, date palm pollen (DPP) has been shown to produce gonadotrophic hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH).⁵⁰ Estrogen plays a pivotal role in adult females by regulating the estrous cycle and influencing various physiological processes such as pregnancy, lactation, and libido. Progesterone, the primary progestin hormone, is synthesized by the ovaries during the middle of the estrous cycle and is produced in substantial quantities by the placenta during pregnancy.⁵¹

In a study on palm pollen, the efficacy of DPP on ovarian parameters in female mice was evaluated. The study found significant increases in ovarian diameter, the count of primary and secondary follicles, and elevated levels of estrogen and progesterone.¹⁸ Additionally, phytoestrogens found in date palm pollen act as weak estrogen antagonists, exhibiting a potent effect in low estrogen environments, such as in cases of polycystic ovary syndrome (PCOS).⁵² El-Wahed et al. demonstrated that date fruit consumption can positively influence the hormonal profile of women with PCOS.³⁸

Premenstrual syndrome (PMS) is associated with hormonal imbalances, including excess estrogen and insufficient progesterone.⁵³ Serotonin levels are also linked to PMS symptoms, which are considered a major etiological factor.⁵⁴ In a study, the inclusion of red Chinese date fruits in the diet of women led to a significant improvement in their emotional well-being, likely attributed to the hormonal properties of date fruits, which alleviated negative moods.⁵⁵

In the context of infertility, scientists are exploring natural remedies for its prevention and treatment. Date fruits have been identified as effective due to their antioxidative properties. In males, date palm influences reproductive factors, including hormone levels, seminal vesicle parameters, sperm motility, count, and viability. In females, date fruit impacts oogenesis, fortifies oocytes, regulates hormones, supports pregnancy, reduces the need for labour augmentation, and helps prevent postpartum hemorrhage.⁵⁶ Studies on the effects of date fruit or its extract capsules on improving fertility and ovarian function further support these findings.^18,36

The onset of menopause marks a phase characterized by a physiological decline in estrogen levels. This leads to changes such as thinning of the vaginal epithelium, flattening of cells, reduced glycogen content, and the disappearance of epithelial-connective papillae.⁵⁷ Date fruits contain flavonoids, alkaloids, sterols, and steroids, which have the potential to improve and regulate sexual activity.^50,58 Alkaloids present in date fruits exhibit ergogenic properties that can induce vasodilation in blood vessels, facilitating sexual response and erection.⁵⁹ Additionally, date palm pollen has been shown to improve vaginal lubrication and reduce dyspareunia, potentially through its effects on increasing sex hormones such as estradiol, progesterone, and testosterone.⁶⁰ Phytochemical analysis of date palm pollen reveals that it is rich in natural antioxidants, including flavonoids, glycosides, saponins, estrone, vitamins A and E, and minerals like bromine, zinc, cadmium, manganese, and copper, as well as fatty acids such as palmitic acid, stearic acid, and linoleic acid.⁶¹ Furthermore, Sadeghi et al. found that consuming date extract capsules for 5 weeks had a positive effect on women's sexual performance, with no side effects.⁶²

The strength of this study lies in the comprehensive collection of studies evaluating the impact of date fruit on various stages of female life. The findings provide valuable insights into the potential effects of date fruit on the female reproductive system. However, the study has some limitations, including a limited number of research articles, small sample sizes, and a lack of control groups in some studies. Additionally, the inclusion of animal studies may limit the generalizability of the findings. To improve the robustness of the conclusions, further human intervention studies at different stages of women's lives are recommended.

5. Conclusion

The findings from this comprehensive review suggest that the inclusion of date fruits in women's diets can significantly alleviate various health issues encountered throughout different life stages. Date fruit consumption has been shown to improve anaemia-related indicators, support hormonal balance, enhance ovulation and metabolic parameters in women with polycystic ovary syndrome (PCOS), and improve sexual function in both men and women. Furthermore, postmenopausal women benefit from improvements in sexual performance. Providing women with proper nutrition, particularly by incorporating date fruits into their diets, offers a cost-effective alternative to medical interventions and serves as a key preventive measure for improving women's health. Empowering women with simple dietary advice can significantly enhance their quality of life and better equip them to navigate the challenges they face throughout life. It is imperative for societies to prioritize the enrichment of women's nutrition and to promote education on the importance of dietary choices at all stages of life.

Ethical Statement

The study protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the identifier CRD42024499896.

Data Availability Statement

The datasets used and/or analysed during the current review are available from the corresponding author upon reasonable request.

Authors' Contribution

FA and ESH conceived, designed and drafted the manuscript. FR, MJ and FA reviewed and interpreted the data. All authors approved the final version of the manuscript.

Acknowledgments

The authors used the “Free AI Paraphrasing Tool” (https://ahrefs.com/writing-tools/paraphrasing-tool) to refine the language of this manuscript. The tool was employed to enhance the academic writing style; however, the authors carefully reviewed and manually edited the entire content to ensure accuracy, coherence, and alignment with the intended meaning.