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Neuroendocrinology

Beyond the ovary: rewiring our perspective on polycystic ovary syndrome

Nature Reviews Endocrinology volume 20, page 257 (2024)Cite this article

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One in ten women of reproductive age is likely to have polycystic ovary syndrome (PCOS), a complex endocrine disorder that affects reproductive, metabolic, cardiovascular and psychological health. PCOS is defined by ovarian dysfunction, including the diagnostic features of androgen excess, reduced or absent ovulation, and polycystic ovarian morphology. However, two seminal studies in the late 1990s challenged the primary role of the ovary in PCOS, and instead implicated intrinsic features in the brain, specifically the gonadotropin-releasing hormone (GnRH) neuronal network, as central to PCOS pathology.

Usually, the reproductive axis features reciprocal communication between a network of neurons in the brain (the GnRH neuronal network) and the gonads. Hormones released from the hypothalamus, pituitary and gonads (HPG) are key parts of this communication. Patterned, pulsatile release of GnRH from the hypothalamus promotes pituitary release of luteinizing hormone (LH) and follicle-stimulating hormone, which together regulate ovarian function. Gonadal hormones, in turn, provide essential feedback signals to the brain and pituitary to shape GnRH and LH release.

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References

Original articles

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Related articles

  • Sullivan, S. D. & Moenter, S. M. Prenatal androgens alter GABAergic drive to gonadotropin-releasing hormone neurons: implications for a common fertility disorder. Proc. Natl Acad. Sci. USA 101, 7129–7134 (2004)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Silva, M. S. B. et al. Overactivation of GnRH neurons is sufficient to trigger polycystic ovary syndrome-like traits in female mice. EBioMedicine 97, 104850 (2023)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Centre for Neuroendocrinology and Department of Physiology, University of Otago School of Biomedical Sciences, Dunedin, New Zealand

    Rebecca E. Campbell

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  1. Rebecca E. Campbell
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Correspondence to Rebecca E. Campbell.

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The author declares no competing interests.

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Cite this article

Campbell, R.E. Beyond the ovary: rewiring our perspective on polycystic ovary syndrome. Nat Rev Endocrinol 20, 257 (2024). https://doi.org/10.1038/s41574-024-00963-3

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  • DOI: https://doi.org/10.1038/s41574-024-00963-3

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