The relationship between psychological stress and ovulatory disorders and its molecular mechanisms: a narrative review

This narrative review explores the relationship between psychological stress and ovulatory disorders, focusing on the molecular mechanisms involved. Ovulation is regulated by the hypothalamus-pituitary-ovarian (HPO) axis, and disruptions in this axis can lead to ovulatory dysfunction. Chronic psychological stress affects the HPO axis, resulting in abnormalities in hypothalamus hormone secretion, pituitary hormone release, and ovarian function. These disruptions cause ovulation disorders and menstrual irregularities. The mechanisms by which psychological stress affects ovulation involve alterations in neuropeptides and hormones, activation of the hypothalamic-pituitary-adrenal (HPA) axis, impairment of follicular development, generation of oxidative stress, and the decline in ovarian reserve function. Understanding these mechanisms is crucial for developing interventions to restore reproductive health. Psychological interventions, such as cognitive-behavioral therapy, have shown promise in improving ovulation and pregnancy rates in women with ovulatory disorders. Further research is needed to explore the specific mechanisms of these interventions and optimize treatment strategies. Addressing psychological factors is essential in managing reproductive health and ovulatory disorders.