Obesity and gonadal function of women

Excessive visceral adiposity is associated with metabolic and reproductive abnormalities. Adipose tissue is an active endocrine gland and participates in multiple mechanisms in the reproductive function of women. The nature of the complex interaction of obesity with the female reproductive function remains a challenge. Several links have been implicated in the gonadal dysfunction of obese women, like insulin resistance and hyperinsulinemia, via which ovarian androgen production is stimulated resulting in hyperandrogenemia, increased peripheral aromatization of androgens to estrogens, altered gonadotrophin secretion, decreased sex hormone binding globulin, decreased GH and IGFBPs, increased leptin levels and altered neuroregulation of the hypothalamic-pituitary-gonadal axis. The impact of obesity in these mechanisms and their influence on female reproductive function are discussed in this article.