Ovarian Aging: Mechanisms, Age-Related Disorders, and Therapeutic Interventions

Ovarian aging is a fundamental process in female reproductive biology with broad implications for overall health and aging. As global populations age, understanding its mechanisms and systemic effects has gained urgent clinical relevance. The ovary, beyond its reproductive role, is increasingly recognized as a regulator of systemic aging due to the widespread presence of estrogen receptors. Declining ovarian function accelerates not only reproductive senescence but also contributes to age-related disorders including osteoporosis, neurodegenerative diseases, and cardiovascular conditions. However, research on ovarian aging remains fragmented, lacking integrative analysis. This review synthesizes recent advances in the cellular and molecular mechanisms underpinning ovarian aging, such as genomic instability, metabolic and oxidative stress, and microenvironmental alterations. It further discusses how ovarian decline influences systemic aging pathways and disease susceptibility and evaluates emerging therapeutic strategies such as antioxidant interventions, stem cell therapy, and ovarian tissue transplantation. By providing a comprehensive overview of ovarian aging from mechanisms to interventions, this review aims to bridge existing knowledge gaps and inspire future research toward improving women's healthspan and quality of life.