title: Energy metabolism and fertility: a balance preserved for female health.
abstract: In female animals, energy metabolism and fertility are tightly connected, and reciprocally regulated. However, the relative contributions of metabolic and reproductive pathways have changed over the course of evolution. In oviparous animals, metabolic factors take precedence over fertility, enabling egg production to be inhibited in a nutritionally poor environment. By contrast, in placental mammals, the opposite occurs: the need to feed a developing embryo and neonate forces metabolic pathways to adapt to these reproductive needs. This physiological necessity explains why in female mammals alterations of gonadal activity, including age-dependent cessation of ovarian functions, are associated with a disruption of metabolic homeostasis and consequent inflammatory reactions that trigger the onset of metabolic, cardiovascular, skeletal and neural pathologies. This Review discusses how metabolic homeostasis and reproductive functions interact to optimize female fertility and explains the pathogenic mechanisms underlying the disordered energy metabolism associated with human ovarian dysfunction owing to menopause, polycystic ovary syndrome and Turner syndrome. Finally, this article highlights how hormone replacement therapy might aid the restoration of metabolic homeostasis in women with ovarian dysfunction.
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Della Torre
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Benedusi
authors.affiliation: Department of Drug Discovery and Development, Italian Institute of Technology, Via Morego 30, 16163 Genoa, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Fontana
authors.affiliation: Centre of Excellence on Neurodegenerative Diseases, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Maggi
mesh_terms: D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology*; D020249:Hormone Replacement Therapy; D006801:Humans; D010053:Ovary / Q000503:physiopathology; D012098:Reproduction / Q000502:physiology; D016387:Women's Health