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心理应激与排卵障碍的关系及其分子机制:叙述性综述。

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

机构信息

Assisted Reproduction Unit, Department of Gynecology and Obstetrics, Sir Run Run Shaw Hospital, Hangzhou, China.

出版信息

J Psychosom Obstet Gynaecol. 2024 Dec;45(1):2418110. doi: 10.1080/0167482X.2024.2418110. Epub 2024 Oct 22.

Abstract

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.

摘要

这篇综述探讨了心理压力与排卵障碍之间的关系,重点关注其中涉及的分子机制。排卵受下丘脑-垂体-卵巢(HPO)轴的调节,该轴的紊乱可导致排卵功能障碍。慢性心理压力会影响 HPO 轴,导致下丘脑激素分泌、垂体激素释放和卵巢功能异常。这些紊乱导致排卵障碍和月经不规律。心理压力影响排卵的机制涉及神经肽和激素的改变、下丘脑-垂体-肾上腺(HPA)轴的激活、卵泡发育受损、氧化应激的产生以及卵巢储备功能的下降。了解这些机制对于开发恢复生殖健康的干预措施至关重要。心理干预,如认知行为疗法,已显示出在改善排卵障碍妇女的排卵和妊娠率方面的潜力。需要进一步研究来探索这些干预措施的具体机制,并优化治疗策略。解决心理因素对于管理生殖健康和排卵障碍至关重要。

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