Neuromodulation in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder associated with an aberrant gonadotropin-releasing hormone (GnRH) secretory pattern culminating in elevated luteinizing hormone and relatively suppressed follicle-stimulating hormone levels. Several factors have been implicated in the pathogenesis of this aberration. Neurotransmitters are believed to play an important role in the central modulation GnRH drive in PCOS. Peripheral signals may directly or indirectly modulate GnRH signals. This article reviews some of the neural mechanisms implicated in the etiology of the GnRH aberrations characteristic of PCOS. Identification of one or more etiologic factors may have implications in developing specific treatment strategies for women with PCOS in the future.