Hyperprolactinemia, defined as persistently elevated serum prolactin levels, is a common endocrine disorder with systemic metabolic consequences that extend beyond its classical roles in lactation and reproductive function. This review summarizes current evidence regarding the interplay between prolactin excess and metabolic regulation. Chronic hyperprolactinemia is associated with increased appetite, weight gain, and elevated BMI, likely mediated through altered dopaminergic tone, leptin resistance, and direct effects on adipose tissue. Dyslipidemia is frequently observed, characterized by elevated total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides, alongside reduced high-density lipoprotein cholesterol (HDL-C). Additionally, prolactin excess contributes to impaired glucose homeostasis, manifesting as increased fasting glucose levels, elevated HbA1c, and insulin resistance. Emerging data also suggest associations with endothelial dysfunction, cardiovascular risk, neuropsychiatric disturbances, and reduced bone mineral density. These findings support the conceptualization of hyperprolactinemia as a multisystem disorder requiring comprehensive clinical evaluation and management. Further studies are needed to elucidate the underlying mechanisms and optimize therapeutic strategies.

Objective: To evaluate the impact of the menopausal transition on body composition across different body mass categories and to identify menopause-related changes in lean and fat tissue distribution. Methods: This retrospective cross-sectional study included 325 women whose clinical and body composition data were extracted from existing records. Participants were classified as premenopausal (controls), perimenopausal, or postmenopausal and further stratified by body mass index (BMI) into normal-weight, overweight, and obesity groups. Body composition had been assessed using bioelectrical impedance analysis. Results: Across all BMI categories, postmenopausal women demonstrated significantly lower lean body mass, soft lean mass, skeletal muscle mass, total body water, protein, and mineral content compared with premenopausal and perimenopausal women (p < 0.05). Total and visceral fat area (VFA), body fat percentage (BF), and waist-to-hip ratio were significantly higher, indicating a shift toward central adiposity. These changes were most pronounced in normal-weight women (VFA: 36.4 ± 17.0, 48.3 ± 22.3, and 55.7 ± 23.5 cm2; BF: 24.8 ± 5.3%, 27.2 ± 5.2%, and 28.8 ± 4.6% in pre-, peri-, and postmenopause, respectively), and less marked among overweight women (VFA: 91.5 ± 36.3, 106.1 ± 38.2, and 111.7 ± 28.6 cm2; BF: 36.0 ± 3.6%, 36.4 ± 3.9%, and 37.2 ± 3.2%) and with obesity (VFA: 180.3 ± 62.4, 212.6 ± 96.2, and 175.5 ± 54.4 cm2; BF: 44.5 ± 4.5%, 44.5 ± 5.7%, and 41.9 ± 3.3%), suggesting a relative attenuation of muscle loss at higher BMI. Conclusions: Postmenopausal women showed a clear shift toward lower lean mass and greater central adiposity across BMI categories. These patterns indicate a consistent deterioration in body composition during the menopausal transition. Assessment of visceral fat in postmenopausal women is crucial, as its accumulation is closely linked to cardiometabolic risk. Menopause-related hormonal changes favor central adiposity, supporting the use of visceral fat as a key indicator for early risk stratification and preventive interventions in midlife women.

Embryo implantation is a highly regulated, multistep process requiring precise synchronization between a developmentally competent blastocyst and a receptive endometrium. This article outlines the fundamental stages of implantation (apposition, adhesion, and invasion) and highlights the molecular, cellular, and immunological mechanisms underlying successful embryo–endometrial interaction. Uterine receptivity, occurring during the temporally restricted window of implantation, is governed by hormonal regulation and coordinated gene expression, and its disruption represents a key factor in infertility and recurrent implantation failure (RIF). The article further examines the multifactorial etiology of implantation failure, including genetic abnormalities, maternal age, lifestyle influences, immunological imbalance, uterine pathology, and chronic endometrial conditions. Current and emerging therapeutic strategies in assisted reproductive technology (ART) are critically reviewed, with emphasis on their efficacy and limitations. In addition, the paper explores innovative technologies aimed at improving implantation outcomes, including time-lapse imaging, artificial intelligence-based embryo selection, and transcriptomic tools such as endometrial receptivity analysis. Advanced experimental models, particularly microfluidic “womb-on-a-chip” systems and three-dimensional in vitro embryo–endometrial platforms, are highlighted as transformative tools for studying implantation dynamics and enabling personalized therapeutic approaches. Collectively, these advances offer promising avenues for improving reproductive outcomes, although further research and standardization are required to translate these innovations into routine clinical practice.

Abstract:Polycystic ovary syndrome (PCOS) is commonly associated with obesity and metabolic disturbances. Although gut and vaginal microbiome changes have been linked to PCOS, the independent role of body mass index in these alterations remains unclear. This study aimed to compare gut and vaginal microbiomes in women with PCOS and healthy controls, emphasizing the impact of body mass index. Seventy-five women were enrolled, including 55 with PCOS and 20 healthy controls. Participants were stratified into normal-weight (<25) and overweight (≥25) groups. Vaginal and anorectal swabs were analyzed using full-length 16S rRNA nanopore sequencing. Microbial diversity and composition were assessed with alpha diversity indices, principal component analysis, analysis of composition of microbes, PERMANOVA, and vaginal community state type classification. Without body mass index stratification, women with PCOS showed differences in several vaginal taxa compared with healthy controls. Within the PCOS cohort, overweight women exhibited higher vaginal alpha diversity, reduced Lactobacillus dominance, and enrichment of anaerobic taxa compared with normal-weight women with PCOS. Differences in vaginal microbial composition were also observed between healthy and PCOS women with normal body mass index. In contrast, gut microbiome alterations were limited and less consistent across analytical approaches. Vaginal community state type analysis revealed predominance of class IV communities in both healthy women and women with PCOS. These findings suggest that higher body mass index is associated with vaginal microbiome alterations in women with PCOS, although PCOS-related factors independent of body weight may also contribute to the observed microbial differences. Lay summary:Polycystic ovary syndrome is a common condition that affects hormones, fertility, and metabolism in women. Many women with this condition are also overweight, but it is not fully understood how body weight influences the bacteria living in the body. In this study, we compared bacteria present in vaginal and anorectal samples from women with and without polycystic ovary syndrome, while also considering body weight. We found that women with higher body weight had more noticeable changes in vaginal bacterial composition, including lower amounts of protective Lactobacillus bacteria and higher diversity of anaerobic bacteria. At the same time, some bacterial differences were also observed in women with polycystic ovary syndrome who had normal body weight. Changes in gut bacteria were smaller and less consistent. These findings suggest that both body weight and polycystic ovary syndrome may influence vaginal bacterial composition and should be considered in future studies of women's reproductive health.

Background/Objectives: Embryo implantation is a highly regulated, multistep process requiring precise synchronization between a developmentally competent blastocyst and a receptive endometrium. Despite advances in reproductive medicine, implantation failure remains a major limiting factor in assisted reproductive technology (ART), particularly in cases of recurrent implantation failure (RIF). This review aims to summarize current knowledge on the molecular, cellular, and immunological mechanisms governing embryo-endometrial interaction and to evaluate contemporary strategies for optimizing implantation outcomes. Methods: This narrative review synthesizes the current literature on embryo implantation, including studies addressing uterine receptivity, etiological factors contributing to implantation failure, and emerging diagnostic and therapeutic approaches. The review integrates findings from molecular biology, clinical ART practices, and bioengineering-based models. Key areas include transcriptomic tools such as endometrial receptivity analysis, time-lapse imaging, artificial-intelligence-based embryo selection, and advanced in vitro models (e.g., microfluidic "womb-on-a-chip" systems and three-dimensional embryo-endometrial platforms). The literature was identified through major biomedical databases, following a structured but non-systematic approach. Results: Implantation success is dependent on a complex interplay of hormonal regulation, gene expression, immune modulation, and embryo quality. Disruption of uterine receptivity during the window of implantation is a critical contributor to infertility and RIF. Multiple factors-including genetic abnormalities, maternal age, lifestyle influences, immunological imbalance, uterine pathology, and chronic endometrial conditions-are implicated in implantation failure. Emerging technologies, such as AI-assisted embryo selection, transcriptomic profiling, and advanced in vitro implantation models, provide enhanced insight into implantation dynamics and offer potential for improved clinical outcomes. Conclusions: Advances in understanding embryo implantation and the development of innovative diagnostic and therapeutic technologies hold significant promise for improving reproductive success. However, further research, validation, and standardization are required before these approaches can be fully integrated into routine clinical practice. A more personalized and mechanism-based approach to implantation may ultimately enhance ART outcomes and reduce the burden of infertility.

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders affecting women of reproductive age, with an estimated prevalence of 5-10%. Women with PCOS are at increased risk for metabolic disturbances. A significant proportion of women with PCOS, ranging from 40 to 85%, are either overweight or obese. Oral contraception is the standard first line treatment for PCOS. However, certain conditions associated with PCOS, such as obesity, must be considered when deciding to prescribe combined oral contraception. It seems that there is no clinical advantage in using high-dose ethinyl estradiol over low-dose formulations. Lower-dose EE formulations may be considered a safer option for obese PCOS patients. Combined oral contraception containing natural estrogens, which have a beneficial effect on metabolic parameters, could also be a viable option for this group. Progestin-only (POPs) formulations have minimal metabolic effects, making them a safe contraceptive choice for patients with obesity and a high risk of coronary artery disease, cerebrovascular disease, venous thromboembolism, or hypertension. Non-oral contraceptive methods, such as transdermal patches and vaginal rings, offer a valuable alternative for women with PCOS who prefer not to use daily oral contraceptives. However, the absence of anti-androgenic progestins in these contraceptive methods may limit their effectiveness, especially for women with moderate to severe clinical signs of androgen excess. The use of LNG-IUDs in women with PCOS may be beneficial in several ways. First, in cases where other contraceptive methods are contraindicated, the LNG-IUD provides effective contraception while also regulating abnormal uterine bleeding. Additionally, the relative hyperestrogenism associated with anovulation in PCOS can lead to endometrial hyperplasia with atypia and, in severe cases, endometrial cancer. Therefore, in women with both PCOS and obesity, the LNG-IUD may be preferred over oral megestrol acetate for endometrial protection.

KNDy (kisspeptine, neurokinin B, dynorphin) neurons, located in the hypothalamus, play a crucial role in the development of vasomotor symptoms (VSM) in menopausal women. Estrogen withdrawal during menopause leads to the hyperactivation of kisspeptin and neurokinin B (NKB) secretion, contributing to the onset of these symptoms. The identification of NKB/neurokinin B receptor (NK3R) signaling as a key mechanism in menopausal hot flashes has driven the development of NK3R antagonists. These antagonists restore the disrupted balance in KNDy neuron activity caused by estrogen deficiency, thereby reducing the frequency and severity of VMS. In 2023, the FDA approved fezolinetant, the first selective NK3R antagonist, for the treatment of moderate to severe VMS associated with menopause. Additionally, elinzanetant, a dual neurokinin-1 and neurokinin-3 receptor antagonist, has demonstrated promising results. The approval application for elinzanetant was supported by positive findings from the OASIS 1, 2, and 3 Phase III clinical studies. The dual antagonism of NK-1 and NK-3 receptors enhances its efficacy by alleviating menopause-related sleep disturbances and modulating peripheral vasodilatation. In this regard, elinzanetant represents a promising non-hormonal treatment that targets the underlying causes of VMS through NK-1 and NK-3 receptor pathways. The development of neurokinin B antagonist for VMS treatment exemplifies the impact of advanced pharmacological research on gynecological endocrinology.

Ovarian aging is characterized by a gradual decline in both reproductive and endocrine functions, ultimately culminating in the cessation of ovarian activity around the age of 50, when most women experience natural menopause. The decline begins early, as follicular attrition is initiated in utero and continues throughout childhood and reproductive life. Most follicles undergo atresia without progressing through substantial stages of growth. With increasing age, a pronounced reduction occurs in the population of resting follicles within the ovarian reserve, accompanied by a decline in the size of growing follicular cohorts. Around the age of 38, the rate of follicular depletion accelerates, sometimes resulting in diminished ovarian reserve (DOR). The subsequent menopausal transition involves complex, irregular hormonal dynamics, manifesting as increasingly erratic menstrual patterns, primarily driven by fluctuations in circulating estrogens and a rising incidence of anovulatory cycles. In parallel with the progressive depletion of the follicular pool, the serum concentrations of anti-Müllerian hormone (AMH) decline gradually, while reductions in inhibin B levels become more apparent during the late reproductive years. The concomitant decline in both inhibin B and estrogen levels leads to a compensatory rise in circulating follicle-stimulating hormone (FSH) concentrations. Together, these endocrine changes, alongside the eventual exhaustion of the follicular reserve, converge in the onset of menopause, which is defined by the absence of menstruation for twelve consecutive months. The mechanisms contributing to ovarian aging are complex and multifactorial, involving both the oocyte and the somatic cells within the follicular microenvironment. Oxidative stress is thought to play a central role in the age-related decline in oocyte quality, primarily through its harmful effects on mitochondrial DNA integrity and broader aspects of cellular function. Although granulosa cells appear to be relatively more resilient, they are not exempt from age-associated damage, which may impair their hormonal activity and, given their close functional relationship with the oocyte, negatively influence oocyte competence. In addition, histological changes in the ovarian stroma, such as fibrosis and heightened inflammatory responses, are believed to further contribute to the progressive deterioration of ovarian function. A deeper understanding of the biological processes driving ovarian aging has facilitated the development of experimental interventions aimed at extending ovarian functionality. Among these are the autologous transfer of mitochondria and stem cell-based therapies, including the use of exosome-producing cells. Additional approaches involve targeting longevity pathways, such as those modulated by caloric restriction, or employing pharmacological agents with geroprotective properties. While these strategies are supported by compelling experimental data, robust clinical evidence in humans remains limited.

Hormonal contraceptives (HCs) are widely used and generally well tolerated; however, their neuroendocrinological effects remain underappreciated in clinical decision-making. Beyond ovulation suppression, HCs influence brain function by modulating key neurotransmitters such as GABA, serotonin, and dopamine, as well as neurosteroids like allopregnanolone and β-endorphin. These interactions help explain why some users experience mood swings, anxiety, or changes in sexual desire, while others report improvements in well-being. In this narrative review, we explore how different estrogenic and progestin components affect central pathways involved in emotional regulation and cognition. Evidence suggests that estradiol or estetrol-based formulations combined with anti-androgenic progestins like drospirenone or nomegestrol acetate may offer a more favourable neuroendocrine profile, particularly in women with a history of mood disorders or hormonal sensitivity. Understanding these neuroendocrine mechanisms may support more personalized contraceptive choices, particularly in women with mood disorders and hormonal vulnerability.

Preimplantation genetic testing (PGT) has been used in various forms over the last two decades. PGT involves testing early embryos following in vitro fertilization and has now become an accepted part of genetic testing. Nowadays, PGT serves as a resource for couples who have a family history of monogenic disorders, wherein the fetus is at high risk of inheriting the condition. PGT is also used to improve pregnancy outcomes in IVF patients in cases of recurrent IVF implantation failure, recurrent miscarriages, as well as male factor. It is also used in screening for sex-linked disorders and sourcing stem cells for therapy. The latest PGT direction is polygenic embryo screening (PES, PGT-P), which allows the identification of embryos that are at elevated risk for significant diseases in adulthood, such as coronary artery disease (CAD), diabetes, hypertension, and breast cancer. As the prevalence and the potential for the use of PES grow, fundamental ethical issues have been underlined, raising concerns about the broader implications of genetic testing. This narrative review summarizes indications, methods, applications, and limitations for PGT, with a particular focus on PES.

Turner syndrome (TS) is the most common female sex chromosome disorder, occurring in one out of every 2500 to 3000 live female births. It is caused by the partial or complete loss of one X chromosome. TS is associated with certain physical and medical features, including short stature, estrogen deficiency, delayed puberty, hypothyroidism, and congenital heart defects. The majority of women with TS are infertile as a result of gonadal dysgenesis and primary ovarian insufficiency causing hypergonadotropic hypogonadism. Several reproductive options are available for TS patients. The recent use of stem cells (SCs) was found to constitute a promising new alternative in cases of infertility treatment in this group. SCs are undifferentiated cells that exist in embryos, fetuses, and adults and that produce differentiated cells. They can be used in infertility treatment for ovarian regeneration and oocyte generation. However, additional studies scrutinizing their efficiency and safety are needed. In our review, we present reproductive options that are currently available for women with TS.

Objective To evaluate the effects of a combination of carnitines, L-arginine, L-cysteine and myo-inositol on metabolic and reproductive parameters in PCOS overweight/obese patients.Methods This was a retrospective study analyzing information of a group of PCOS (n = 25) overweight/obesity patients, not requiring hormonal treatment, selected from the database of the ambulatory clinic of the Gynecological Endocrinology Center at the University of Modena and Reggio Emilia, Modena, Italy. The hormonal profile, routine exams and insulin and C-peptide response to oral glucose tolerance test (OGTT) were evaluated before and after 12 weeks of a daily oral complementary treatment with L-carnitine (500 mg), acetyl-L-carnitine (250 mg), L-arginine (500 mg), L-cysteine (100 mg) and myo-inositol (1 gr). The hepatic insulin extraction index was also calculated.Results The mix of complementary substances significantly improved metabolic parameters, homeostatic model assessment for insulin resistance index values and gonadotropin plasma levels. Glucose, C-peptide and insulin response to OGTT was significantly reduced as well as the hepatic insulin extraction index.Conclusion The administration of a combination of carnitines, L-arginine, L-cysteine and myoinositol improved gonadotropin plasma levels and insulin sensitivity in overweight/obese PCOS patients and restored hepatic clearance of insulin as demonstrated by the decreased hepatic insulin extraction index.

Background: Infertility remains a significant global health challenge, affecting approximately 15% of couples worldwide. In vitro fertilization (IVF) has transformed reproductive medicine; however, challenges such as low success rates in older patients, ovarian insufficiency, endometrial dysfunction, and male infertility continue to limit outcomes. Objective: This review aims to summarize the principles of IVF and explore the potential role of stem cells in enhancing IVF outcomes, with particular attention to applications in both women and men, as well as the accompanying ethical considerations. Summary: Stem cell research has introduced novel therapeutic opportunities, including ovarian rejuvenation, endometrial regeneration, sperm quality enhancement, and the development of synthetic embryo models. Mesenchymal stem cells (MSCs), embryonic stem cells (ESCs), and induced pluripotent stem cells (iPSCs) demonstrate regenerative properties that may help to overcome current reproductive limitations. Despite encouraging findings from preclinical and early clinical studies, challenges such as tumorigenesis, genetic instability, and ethical controversies remain major barriers to translation. Conclusions: IVF continues to serve as a cornerstone of assisted reproductive technology (ART). Stem cell-based approaches represent an exciting frontier that could expand the therapeutic possibilities of IVF. Careful clinical validation, international regulatory harmonization, and robust ethical oversight will be essential to ensuring safe and equitable implementation.

Introduction: Adolescent alcohol abuse is a critical public health issue with far-reaching consequences for individual development and societal well-being. Adolescent alcohol consumption poses significant health risks, particularly due to its effects on brain development and its association with increased suicide risk. Purpose of the work: This study aims to investigate the relationship between alcohol abuse and suicide risk in adolescents. Materials and methods: A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms including the following keywords: alcohol abuse/ alcohol abuse in adolescence/ alcohol consumption in adolescence/ alcohol abuse and suicide risk in adolescence/ suicide risk factors in adolescence/ suicidal tendencies among teenagers. Conclusions: Adolescent alcohol abuse has profound implications for brain development and mental health, significantly increasing the risk of suicide. Effective public health strategies, including early intervention, education, and strong support systems, are essential to mitigate these risks and promote healthier environments for young individuals. Addressing the underlying causes of alcohol abuse and providing targeted support can reduce its long-term consequences and improve adolescent well-being.

Abstract Introduction: Depression is one of the most common and serious mental health disorders that negatively affects how you feel, think, and act. This syndrome is characterized by stress and emotion dysregulation, involving compromised structural integrity of frontal-limbic networks.It causes persistent feelings of sadness and a lack of interest in activities once enjoyed. Effective treatments, including therapy and medication, are available and can help manage the symptoms and improve quality of life. The aspect of physical activity as a component of depression treatment is currently being intensively studied. Purpose of work: This work provides a review of the knowledge on the relationship between physical activity and depression. Summary: Depression has a profound impact on the personal life, relationships, and work of those affected by the condition. Pharmacological and psychological interventions remain the cornerstone of treatment. However, these treatments do not produce the desired effects in all patients. This article presents the conclusion that physical exercise, as an alternative method for preventing and treating depression, is effective. The recent literature also suggests significant mental health benefits from being physically active, even at levels below the public health recommendations. Therefore, health practitioners should encourage any increase in physical activity to enhance mental health.

Introduction: Erectile dysfunction (ED) represents a significant health problem that can have a negative impact on men's quality of life, intimate relationships and self-esteem. ED is a marker of overall health, requiring a comprehensive diagnostic and therapeutic approach. This article highlights the need for an integrated approach, in which lifestyle modifications are key to the successful treatment of erectile dysfunction. Aim of the study: The aim of this article is to provide a comprehensive review of the literature on erectile dysfunction, with the intention of improving understanding of the condition and providing directions for future research and clinical practice. Materials and methods: Electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, were searched to identify studies and literature reviews on erectile dysfunction (ED). The state of knowledge: This review examines the epidemiology, pathophysiology, and risk factors associated with ED, emphasizing the importance of lifestyle in prevention and treatment. The role of diet, physical activity, weight reduction, smoking cessation, and alcohol restriction in improving erectile function is discussed. The article also presents current diagnostic and therapeutic approaches, including pharmacotherapy, alternative therapies and psychological interventions. Conclusions: Erectile dysfunction (ED) is a complex health issue that necessitates a comprehensive and interdisciplinary diagnostic and therapeutic approach. Lifestyle plays a pivotal role in the prevention and treatment of ED, and its modification should be an integral component of any treatment plan.

Introduction Women who want to get pregnant soon often ask their doctors how to prepare best. During such a visit, doctors usually mention folic acid supplementation, a check-up with the dentist and gynaecologist or vaccinations. However, it is also worth pointing out the importance of lifestyle factors that affect fertility and fetal development. Modifying daily habits can improve fertility naturally and make getting pregnant faster. An increasing number of studies are being published on the importance of nutrition, physical activity, sleep, stress, stimulants and other factors on women's reproductive health. This article is a summary of the current state of knowledge in this area. Aim of the study The aim of this study is to review the literature and summarize current state of knowledge on the association between lifestyle factors and female reproductive function. Material and methods of research This literature review based on researches from PubMed platform. We searched articles describing connection between potentially modifiable lifestyle factors and women’s fertility. Search terms included keywords: „lifestyle”, „female fertility”, „obesity”, „sleep”, „nutrition”, „diet”, „stress”, „physical activity”, „smoking”, „alcohol”, „weight loss”, „reproductive health”.

This literature review examines the pivotal role of physical activity in the treatment and rehabilitation of children with Fetal Alcohol Syndrome (FAS). By analysing a range of research studies, this review identifies the beneficial impact of structured physical activity programmes on motor skills, cognitive functions, and behavioural outcomes in children with FAS. Furthermore, it proposes educational recommendations for integrating physical activity into therapeutic interventions.