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Published in: Current Obesity Reports 1/2024

Open Access 03-01-2024 | Polycystic Ovary Syndrome | Review

Hypothalamic-Ovarian axis and Adiposity Relationship in Polycystic Ovary Syndrome: Physiopathology and Therapeutic Options for the Management of Metabolic and Inflammatory Aspects

Authors: Maria Serena Lonardo, Nunzia Cacciapuoti, Bruna Guida, Mariana Di Lorenzo, Martina Chiurazzi, Simona Damiano, Ciro Menale

Published in: Current Obesity Reports | Issue 1/2024

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Abstract

Purpose of Review

The goal of the present review is to address the main adiposity-related alterations in Polycystic Ovary Syndrome (PCOS) focusing on hypothalamic-pituitary-ovarian (H-P-O) axis and to provide an overview of nutraceutical and pharmacological therapeutic strategies.

Recent Findings

Female reproduction is a complex and delicate interplay between neuroendocrine signals involving the H-P-O axis. Elements that disrupt the balance of these interactions can lead to metabolic and reproductive disorders, such as PCOS. This disorder includes menstrual, metabolic, and biochemical abnormalities as well as hyperandrogenism, oligo-anovulatory menstrual cycles, insulin resistance, and hyperleptinemia which share an inflammatory state with other chronic diseases. Moreover, as in a self-feeding cycle, high androgen levels in PCOS lead to visceral fat deposition, resulting in insulin resistance and hyperinsulinemia, further stimulating ovarian and adrenal androgen production.
In fact, regardless of age and BMI, women with PCOS have more adipose tissue and less lean mass than healthy women. Excessive adiposity, especially visceral adiposity, is capable of affecting female reproduction through direct mechanisms compromising the luteal phase, and indirect mechanisms as metabolic alterations able to affect the function of the H-P-O axis.

Summary

The intricate crosstalk between adiposity, inflammatory status and H-P-O axis function contributes to the main adiposity-related alterations in PCOS, and alongside currently available hormonal treatments, nutraceutical and pharmacological therapeutic strategies can be exploited to treat these alterations, in order to enable a more comprehensive synergistic and tailored treatment.
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Metadata
Title
Hypothalamic-Ovarian axis and Adiposity Relationship in Polycystic Ovary Syndrome: Physiopathology and Therapeutic Options for the Management of Metabolic and Inflammatory Aspects
Authors
Maria Serena Lonardo
Nunzia Cacciapuoti
Bruna Guida
Mariana Di Lorenzo
Martina Chiurazzi
Simona Damiano
Ciro Menale
Publication date
03-01-2024
Publisher
Springer US
Published in
Current Obesity Reports / Issue 1/2024
Electronic ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-023-00531-2

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