Fisiología del eje hipotálamo-hipófisis-ovario en la regulación del ciclo menstrual de mujeres en etapa perimenopáusica: Physiology of the hypothalamic-pituitary-ovarian axis in the regulation of the menstrual cycle in perimenopausal women

Brisayda Mabet Torrealva Lázaro; Jheremy Jherly Teodoro Maza; Ariana Valeria Silva Carranza; Nayely Xiomara Soto Aguilar; Oscar Lenin López Amaya

doi:10.57188/ricsa.2026.006

Authors

Brisayda Mabet Torrealva Lázaro Escuela profesional de Medicina Humana, Universidad Nacional del Santa, Nuevo Chimbote, Perú. https://orcid.org/0009-0006-4800-6104 (unauthenticated)
Jheremy Jherly Teodoro Maza Escuela profesional de Medicina Humana, Universidad Nacional del Santa, Nuevo Chimbote, Perú. https://orcid.org/0009-0006-8854-9429 (unauthenticated)
Ariana Valeria Silva Carranza Escuela profesional de Medicina Humana, Universidad Nacional del Santa, Nuevo Chimbote, Perú. https://orcid.org/0009-0005-5691-7883 (unauthenticated)
Nayely Xiomara Soto Aguilar Escuela profesional de Medicina Humana, Universidad Nacional del Santa, Nuevo Chimbote, Perú. https://orcid.org/0009-0009-4844-5846 (unauthenticated)
Oscar Lenin López Amaya Escuela profesional de Medicina Humana, Universidad Nacional del Santa, Nuevo Chimbote, Perú. https://orcid.org/0000-0002-4200-5120 (unauthenticated)

DOI:

https://doi.org/10.57188/ricsa.2026.006

Keywords:

Type 2 Diabetes Mellitus (DM II); Obesity; HCV; HBV; HIV; Hepatic Steatosis; Gender. (Source: DeCS-BIREME)

Abstract

This review describes the physiology of the hypothalamic–pituitary–ovarian (HPO) axis, its neuroendocrine regulation, and its role in menstrual cycle variability during the perimenopausal transition. A narrative review was conducted focusing on pulsatile GnRH secretion, pituitary responses of FSH and LH, ovarian steroidogenesis, and age-related ovarian changes. Perimenopause is characterized by progressive disruption of negative feedback mechanisms, with decreased inhibin B and anti-Müllerian hormone levels, marked estradiol fluctuations, and irregular elevations of FSH, leading to anovulatory cycles and menstrual irregularity. Hormonal variability also affects the central nervous system, modulating neurotransmitters, thermoregulation, and cerebral metabolism. Understanding these mechanisms helps explain neuroendocrine symptoms and supports clinical strategies based on hormonal education, individualized management, and metabolic monitoring.

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Physiology of the hypothalamic-pituitary-ovarian axis in the regulation of the menstrual cycle in perimenopausal women