Neuroendocrine, Endocrine and Metabolic Triggers of Impaired Female Reproduction

A special issue of Endocrines (ISSN 2673-396X). This special issue belongs to the section "Female Reproductive System and Pregnancy Endocrinology".

Deadline for manuscript submissions: closed (20 June 2021) | Viewed by 51106

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, Gynecological Endocrinology Center, University of Modena and Reggio Emilia, Modena, Italy
Interests: neuroendocrine/endocrine control of reproduction; hypothalamic dysfunctions; PCOS; obesity; hyperinsulinism; peri and postmenopausal disturbances
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Special Issue Information

Dear Colleagues,

When dealing with abnormal menstrual occurrence or with inability to conceive, many issues can be taken in consideration. Stress, impaired metabolism, PCOS, ovarian failure, endocrine diseases, excess physical activity, or psychodynamic aspects can be effective in negatively modulating the reproductive axis, resulting in a defective reproductive ability.

This Special Issue aims to review the current knowledge and clinical experience of the many situations that have an impact on female reproductive function from adolescence to premenopause, from physiopathology to putative treatment options.

Prof. Dr. Alessandro Genazzani
Guest Editor

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Keywords

  • neuroendocrinology 
  • NPY, kisspeptin, opioids, neuropeptides 
  • stress 
  • PCOS 
  • insulin resistance 
  • endocrine diseases 
  • ovarian failure

Published Papers (7 papers)

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Research

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8 pages, 270 KiB  
Communication
PCOS and Assisted Reproduction Technique: Role and Relevance of Inositols
by Paolo Giovanni Artini, Elisa Malacarne and Vito Cela
Endocrines 2021, 2(4), 515-522; https://doi.org/10.3390/endocrines2040046 - 10 Dec 2021
Viewed by 2368
Abstract
Polycystic ovary syndrome is an endocrine disorder often characterized by insulin resistance and hyperinsulinemia, especially in overweight/obese women. Among insulin sensitizers, the positive role of inositols has been increasingly established in recent years. The action of inositols not only concerns the metabolic parameters [...] Read more.
Polycystic ovary syndrome is an endocrine disorder often characterized by insulin resistance and hyperinsulinemia, especially in overweight/obese women. Among insulin sensitizers, the positive role of inositols has been increasingly established in recent years. The action of inositols not only concerns the metabolic parameters of these patients, but also the hormonal profile, resulting in beneficial effects on ovarian function. For this reason, many studies have tried to recognize their role in PCOS infertile women who underwent in vitro fertilization (IVF) procedures. Full article

Review

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8 pages, 266 KiB  
Review
Kisspeptin Modulation of Reproductive Function
by Anna Szeliga and Blazej Meczekalski
Endocrines 2022, 3(3), 367-374; https://doi.org/10.3390/endocrines3030029 - 30 Jun 2022
Cited by 4 | Viewed by 2468
Abstract
Kisspeptin is a peptide expressed mainly in the infundibular nucleus of the hypothalamus. Kisspeptin plays a crucial role in the regulation of reproductive functions. It is regarded as the most important factor responsible for the control of the hypothalamic–pituitary–gonadal axis, the onset of [...] Read more.
Kisspeptin is a peptide expressed mainly in the infundibular nucleus of the hypothalamus. Kisspeptin plays a crucial role in the regulation of reproductive functions. It is regarded as the most important factor responsible for the control of the hypothalamic–pituitary–gonadal axis, the onset of puberty, and the regulation of menstruation and fertility. Kisspeptin activity influences numerous processes such as steroidogenesis, follicular maturation, ovulation, and ovarian senescence. The identification of kisspeptin receptor mutations that cause hypogonadotropic hypogonadism has initiated studies on the role of kisspeptin in puberty. Pathologies affecting the neurons secreting kisspeptin play a major role in the development of PCOS, functional hypothalamic amenorrhea, and perimenopausal vasomotor symptoms. Kisspeptin analogs (both agonists and antagonists), therefore, may be beneficial as therapy in those afflicted with such pathologies. The aim of this review is to summarize the influence of kisspeptin in the physiology and pathology of the reproductive system in humans, as well as its potential use in therapy. Full article
18 pages, 893 KiB  
Review
Estro-Progestins and Pain Relief in Endometriosis
by Libera Troìa and Stefano Luisi
Endocrines 2022, 3(2), 349-366; https://doi.org/10.3390/endocrines3020028 - 10 Jun 2022
Cited by 3 | Viewed by 5771
Abstract
Endometriosis is a benign, hormone-responsive chronic disease that affects women of reproductive age; long-term treatment to balance satisfactory tolerability with clinical efficacy is necessary for these patients. The first-line therapy for endometriosis is predominantly medical treatment, in order to improve symptoms or prevent [...] Read more.
Endometriosis is a benign, hormone-responsive chronic disease that affects women of reproductive age; long-term treatment to balance satisfactory tolerability with clinical efficacy is necessary for these patients. The first-line therapy for endometriosis is predominantly medical treatment, in order to improve symptoms or prevent post-surgical disease recurrence. Multiple factors including age and women preference, pain severity, and endometriosis stage must be considered in the choice of the most suitable therapy. Estrogen-progestogins are generally used as first-line hormone therapies among different medical options currently effective for endometriosis management. Several studies have shown that they are able to improve pain symptoms in most patients, are well tolerated, and are inexpensive. Combined hormonal contraception treatment, administered cyclically or continuously, with different types of hormones and route of administration, results in clinically noticeable decrease in dysmenorrhea, noncyclic pelvic pain, dyspareunia, and recurrence rate after surgery, and also in quality of life improvement. Full article
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12 pages, 1059 KiB  
Review
Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders
by Rossella E. Nappi, Laura Cucinella, David Bosoni, Alessandra Righi, Federica Battista, Pietro Molinaro, Giulia Stincardini, Manuela Piccinino, Roberta Rossini and Lara Tiranini
Endocrines 2022, 3(1), 127-138; https://doi.org/10.3390/endocrines3010012 - 16 Mar 2022
Cited by 6 | Viewed by 10955
Abstract
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase of the menstrual cycle and impair daily life activities and relationships. Depending on the type and severity of physical, emotional or behavioral symptoms, women [...] Read more.
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase of the menstrual cycle and impair daily life activities and relationships. Depending on the type and severity of physical, emotional or behavioral symptoms, women of reproductive age followed for at least two prospective menstrual cycles may receive one of the two diagnoses. PMDD is the most severe form of PMS, predominantly characterized by emotional and behavioral symptoms not due to another psychiatric disorder. PMS and PMDD are common neuro-hormonal gynecological disorders with a multifaceted etiology. Gonadal steroid hormones and their metabolites influence a plethora of biological systems involved in the occurrence of specific symptoms, but there is no doubt that PMS/PMDD are centrally based disorders. A more sensitive neuroendocrine threshold to cyclical variations of estrogens and progesterone under physiological and hormonal therapies is present. Moreover, altered brain sensitivity to allopregnanolone, a metabolite of progesterone produced after ovulation potentiating GABA activity, along with an impairment of opioid and serotoninergic systems, may justify the occurrence of emotional and behavioral symptoms. Even neuro-inflammation expressed via the GABAergic system is under investigation as an etiological factor of PMS/PMDD. Pharmacological management aims to stabilize hormonal fluctuations and to restore the neuroendocrine balance. The rationale of suppressing ovulation supports prescription of combined hormonal contraception (CHC). Its effect on mood is highly variable and depends on biochemical characteristics of exogenous steroids and on type and severity of symptoms. Hormonal regimens reducing the estrogen-free interval or suppressing menstruation seem better choices. Psychoactive agents, such as serotonin reuptake inhibitors (SSRIs), are effective in reducing the symptoms of PMS/PMDD and may be prescribed continuously or only during the luteal phase. Novel therapeutic approaches include inhibition of progesterone receptors in the brain, i.e., with ulipristal acetate, reduced conversion of progesterone with dutasteride, and modulation of the action of allopregnanolone on the brain GABAergic system with sepranolone. Full article
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12 pages, 4487 KiB  
Review
Neuroendocrine Changes during Menopausal Transition
by Andrea Giannini, Marta Caretto, Andrea R. Genazzani and Tommaso Simoncini
Endocrines 2021, 2(4), 405-416; https://doi.org/10.3390/endocrines2040036 - 14 Oct 2021
Cited by 9 | Viewed by 6945
Abstract
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant [...] Read more.
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant moment. Symptoms of menopause range from somatic side such as metabolic changes, increased cardiovascular disease, irregular vaginal bleeding, urogenital symptoms, vaginal dryness, osteoporosis and risk of bones fractures to changes of central nervous system as vasomotor symptoms, sleep disruption, mood changes, migraine, sexual dysfunctions. It is fundamental to know the mechanisms underlying changes in the central nervous system during menopause, related to hypoestrogenism, to be able to create appropriate target therapy for patients, improving their quality of life. In fact, the central nervous system is now one of the major targets of sex steroids that cannot be achieved disregard when dealing with the problem of choice of a particular type of MHT. Full article
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9 pages, 519 KiB  
Review
Functional Hypothalamic Amenorrhea: A Stress-Based Disease
by Agnieszka Podfigurna and Blazej Meczekalski
Endocrines 2021, 2(3), 203-211; https://doi.org/10.3390/endocrines2030020 - 24 Jul 2021
Cited by 8 | Viewed by 16392
Abstract
The aim of the study is to present the problem of functional hypothalamic amenorrhea, taking into account any disease and treatment, diagnosis, and consequences of this disease. We searched PubMed (MEDLINE) and included 38 original and review articles concerning functional hypothalamic amenorrhea. Functional [...] Read more.
The aim of the study is to present the problem of functional hypothalamic amenorrhea, taking into account any disease and treatment, diagnosis, and consequences of this disease. We searched PubMed (MEDLINE) and included 38 original and review articles concerning functional hypothalamic amenorrhea. Functional hypothalamic amenorrhea is the most common cause of secondary amenorrhea in women of childbearing age. It is a reversible disorder caused by stress related to weight loss, excessive exercise and/or traumatic mental experiences. The basis of functional hypothalamic amenorrhea is hormonal, based on impaired pulsatile GnRH secretion in the hypothalamus, then decreased secretion of gonadotropins, and, consequently, impaired hormonal function of the ovaries. This disorder leads to hypoestrogenism, manifested by a disturbance of the menstrual cycle in the form of amenorrhea, leading to anovulation. Prolonged state of hypoestrogenism can be very detrimental to general health, leading to many harmful short- and long-term consequences. Treatment of functional hypothalamic amenorrhea should be started as soon as possible, and it should primarily involve lifestyle modification. Only then should pharmacological treatment be applied. Importantly, treatment is most often long-term, but it results in recovery for the majority of patients. Effective therapy, based on multidirectional action, can protect patients from numerous negative impacts on fertility, cardiovascular system and bone health, as well as reducing mental morbidity. Full article
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18 pages, 692 KiB  
Review
Sex Differences in Renal Function: Participation of Gonadal Hormones and Prolactin
by Adriana Franco-Acevedo, Raquel Echavarria and Zesergio Melo
Endocrines 2021, 2(3), 185-202; https://doi.org/10.3390/endocrines2030019 - 5 Jul 2021
Cited by 5 | Viewed by 4853
Abstract
Kidney pathophysiology is influenced by gender. Evidence suggests that kidney damage is more severe in males than in females and that sexual hormones contribute to this. Elevated prolactin concentration is common in renal impairment patients and is associated with an unfavorable prognosis. However, [...] Read more.
Kidney pathophysiology is influenced by gender. Evidence suggests that kidney damage is more severe in males than in females and that sexual hormones contribute to this. Elevated prolactin concentration is common in renal impairment patients and is associated with an unfavorable prognosis. However, PRL is involved in the osmoregulatory process and promotes endothelial proliferation, dilatation, and permeability in blood vessels. Several proteinases cleavage its structure, forming vasoinhibins. These fragments have antagonistic PRL effects on endothelium and might be associated with renal endothelial dysfunction, but its role in the kidneys has not been enough investigated. Therefore, the purpose of this review is to describe the influence of sexual dimorphism and gonadal hormones on kidney damage, emphasizing the role of the hormone prolactin and its cleavage products, the vasoinhibins. Full article
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