Metabolic hormones are integral regulators of female reproductive health and function

Abstract

The female reproductive system is strongly influenced by nutrition and energy balance. It is well known that food restriction or energy depletion can induce suppression of reproductive processes, while overnutrition is associated with reproductive dysfunction. However, the intricate mechanisms through which nutritional inputs and metabolic health are integrated into the coordination of reproduction are still being defined. In this review, we describe evidence for essential contributions by hormones that are responsive to food intake or fuel stores. Key metabolic hormones—including insulin, the incretins (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1), growth hormone, ghrelin, leptin, and adiponectin—signal throughout the hypothalamic-pituitary-gonadal axis to support or suppress reproduction. We synthesize current knowledge on how these multifaceted hormones interact with the brain, pituitary, and ovaries to regulate functioning of the female reproductive system, incorporating in vitro and in vivo data from animal models and humans. Metabolic hormones are involved in orchestrating reproductive processes in healthy states, but some also play a significant role in the pathophysiology or treatment strategies of female reproductive disorders. Further understanding of the complex interrelationships between metabolic health and female reproductive function has important implications for improving women's health overall.

The association between leptin, adiponectin levels and the ovarian reserve in women of reproductive age

“…Leptin plays crucial role in regulating female reproductive health through distinct molecular pathways. Leptin, primarily secreted by adipose tissue, acts on the hypothalamus to stimulate the release of gonadotropin-releasing hormone (GnRH), thereby influencing the menstrual cycle and fertility (3)(4)(5). Leptin concentrations are directly related to body fat content (6).…”

“…The most widely released adipokine that is only expressed in adipose tissue is called adiponectin (2,14). adiponectin modulates reproductive function by affecting ovarian steroidogenesis and folliculogenesis, contributing to the regulation of ovulation and fertility (5). Three distinct forms of adiponectin have been identified: low molecular weight adiponectin, hexamer adiponectin, and high molecular weight adiponectin (15).…”

“…Suboptimal reproductive health, such as irregular menstrual cycles or polycystic ovarian syndrome (PCOS), can disrupt the balance of hormones involved in metabolism, including leptin and adiponectin. In conditions like PCOS, alterations in insulin sensitivity and ovarian function can lead to elevated leptin levels and decreased adiponectin levels, contributing to metabolic disturbances and further exacerbating reproductive dysfunction (3)(4)(5).…”