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Neuroimaging

Metabolic tuning during the menstrual cycle

Nature Metabolism volume 5, pages 1449–1451 (2023)Cite this article

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As most studies on the action of insulin in the brain have focused on men, metabolic changes during the menstrual cycle in women remain poorly understood. Using intranasal insulin administration during hyperinsulinaemic–euglycaemic clamps and functional MRI, Hummel et al. show reduced insulin sensitivity during the luteal phase.

Reproduction is an energetically expensive biological process. Consequently, sufficient energy stores are required for ovulation, gestation and lactation in order for reproduction to occur. To optimize reproductive success in relation to available energy, the menstrual cycle and corresponding metabolic changes can be regarded as an adaptive mechanism of the body to maintain energy homeostasis1. In light of this known interplay between energy metabolism and reproductive function, it is perhaps surprising that changes in central insulin sensitivity throughout the menstrual cycle have received little attention. So far, most experimental studies have focused on regulatory processes in men owing to potentially complex interactions with fluctuating levels of various sex hormones1. In contrast to this common concern, a recent meta-analysis of studies that have used continuous glucose monitoring to estimate peripheral insulin sensitivity in women with type 1 diabetes found limited convergence across observational studies2, indicating the demand for mechanistic and experimental work on cycle-dependent changes in insulin sensitivity.

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Fig. 1: Intranasal administration of insulin uncovers a heightened insulin sensitivity in women during the follicular phase of the menstrual cycle.

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Acknowledgements

I thank A. Kühnel for valuable feedback on a draft of this work. I received support from the Deutsche Forschungsgemeinschaft, DFG KR 4555/7-1, KR 4555/9-1, KR 4555/10-1 and IRTG 2804.

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  1. Section of Medical Psychology, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Bonn, Bonn, Germany

    Nils B. Kroemer

  2. Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany

    Nils B. Kroemer

  3. German Center for Mental Health, Tübingen, Germany

    Nils B. Kroemer

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Correspondence to Nils B. Kroemer.

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Kroemer, N.B. Metabolic tuning during the menstrual cycle. Nat Metab 5, 1449–1451 (2023). https://doi.org/10.1038/s42255-023-00867-y

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