Съвременен поглед върху регулацията на хипоталамохипофизо-надбъбречна и гонадна ос при жени и връзката между тях като основа за развитие на овулаторна дисфункция.

Multiple factors, such as stress, excessive deviations in body weight (obesity and cachexia), eating disorders, including anorexia nervosa, energy-deficient conditions and insulin resistance affect women's reproductive health due to dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis and the following ovulatory dysfunction, categorized as hypothalamic hypogonadism, that may present with menstrual cycle disturbances and/ or infertility. The kisspeptinergic system is the one that links stress, nutrition and reproductive signals and plays a key role in maintaining normal pulsatility of gonadotropin-releasing hormone (GnRH) and ovulation. In addition to leptin and insulin, elevated corticotropin-releasing hormone (CRH) and the activation of hypothalamic-pituitary-adrenal (HPA) axis are thought to be key modulators of ovulatory dysfunction. Neuroendocrine regulation of the reproductive processes is a subject of intense research, having in mind the global increase in the incidence of infertility. The purpose of this review is to present the effector elements of the HPG and HPA axis, to gather the available information about the markers and regulators, that are known to date - kiss-peptins, adipocytokines, appetite modulators, as well as to present some newly discovered neuro-peptides (spexin and phoenixin), that are involved in the modulation of reproductive functions, with the potential to reveal new mechanisms in the pathogenesis and to discover new possibilities for the treatment of ovulatory dysfunctions. [ABSTRACT FROM AUTHOR]