Stress and the female reproductive system
Stress and the female reproductive system
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DOI：
10.1016/j.jri.2003.09.004
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发表时间：
2004-06-01
影响因子：
3.4
通讯作者：
Chrousos, GP
中科院分区：
文献类型：
--
作者：
Kalantaridou, SN;Makrigiannakis, A;Chrousos, GP
下丘脑-垂体-肾上腺（HPA）轴在受到压力激活时会对女性生殖系统产生抑制作用。促肾上腺皮质激素释放激素（CRH）抑制下丘脑促性腺激素释放激素（GnRH）的分泌，糖皮质激素抑制垂体黄体生成素和卵巢雌激素和孕激素的分泌。这些影响导致了压力引起的“下丘脑”闭经，这种现象在焦虑和抑郁、营养不良、饮食失调和慢性过度运动以及库欣综合征的性腺功能减退症中观察到。此外，促肾上腺皮质激素释放激素及其受体已在大多数女性生殖组织中发现，包括卵巢、子宫和胎盘。此外，促肾上腺皮质激素释放激素在外周炎症部位分泌，发挥炎症作用。生殖促肾上腺皮质激素释放激素通过炎症成分调节生殖功能，例如排卵、黄体溶解、蜕膜化、着床和早期母体耐受。胎盘 CRH 参与妊娠生理和临产。循环胎盘 CRH 是导致妊娠后半期生理性皮质醇增多症的原因。产后，这种皮质醇增多症随后会出现短暂的肾上腺抑制，这可能解释了在此期间观察到的忧郁/抑郁和自身免疫现象增加的原因。 (C) 2004 Elsevier Ireland Ltd. 保留所有权利。
The hypothalamic-pituitary-adrenal (HPA) axis, when activated by stress, exerts an inhibitory effect on the female reproductive system. Corticotropin-releasing hormone (CRH) inhibits hypothalamic gonadotropin-releasing hormone (GnRH) secretion, and glucocorticoids inhibit pituitary luteinizing hormone and ovarian estrogen and progesterone secretion. These effects are responsible for the "hypothalamic" amenorrhea of stress, which is observed in anxiety and depression, malnutrition, eating disorders and chronic excessive exercise, and the hypogonadism of the Cushing syndrome. In addition, corticotropin-releasing hormone and its receptors have been identified in most female reproductive tissues, including the ovary, uterus, and placenta. Furthermore, corticotropin-releasing hormone is secreted in peripheral inflammatory sites where it exerts inflammatory actions. Reproductive corticotropin-releasing hormone is regulating reproductive functions with an inflammatory component, such as ovulation, luteolysis, decidualization, implantation, and early maternal tolerance. Placental CRH participates in the physiology of pregnancy and the onset of labor. Circulating placental CRH is responsible for the physiologic hypercortisolism of the latter half of pregnancy. Postpartum, this hypercortisolism is followed by a transient adrenal suppression, which may explain the blues/depression and increased autoimmune phenomena observed during this period. (C) 2004 Elsevier Ireland Ltd. All rights reserved.