Neuroscience and biobehavioral reviewsJul 8, 2026

Links Between Hormones, Appetite, and Mental Health in Older Women and What This Means for GLP-1 Treatment

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jul 9, 2026

Abstract

Polyendocrine metabolic ovarian syndrome (PMOS) is the most prevalent endocrine disorder in women of reproductive age.

PMOS involves three interacting domains: hypothalamic neuroendocrine dysfunction, appetite dysregulation, and psychological comorbidities.
Key neuroendocrine issues include abnormal GnRH pulsatility, central leptin resistance, and hypothalamic inflammation.
Disordered eating patterns in PMOS may manifest as binge eating disorder, food addiction, and reward pathway dysfunction.
Common psychological comorbidities associated with PMOS include depression, anxiety, and hyperactivity of the HPA axis.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may have therapeutic effects across metabolic, reproductive, and psychological domains.
Further evidence is needed to clarify the reproductive safety and psychiatric effects of GLP-1RAs in PMOS management.

Simplified

Polyendocrine metabolic ovarian syndrome (PMOS) is the most prevalent endocrine disorder in women of reproductive age, yet its management remains fragmented across metabolic, reproductive, and psychological domains. This review uses a descriptive clinical framework-the "neuroendocrine-appetite-mental health triangle"-to organize existing evidence on three interacting pathogenic domains in PMOS: hypothalamic neuroendocrine dysfunction (aberrant GnRH pulsatility, central leptin resistance, and hypothalamic inflammation), appetite dysregulation and disordered eating (binge eating disorder, food addiction, and reward pathway dysfunction), and psychological comorbidities (depression, anxiety, and HPA axis hyperactivity). Within this framework, we evaluate the therapeutic potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs), whose central and peripheral mechanisms may address multiple aspects of this pathology. We synthesize current evidence on their metabolic, reproductive, and emerging psychotropic effects, while providing a balanced and objective assessment of their safety profile, with particular emphasis on the unresolved questions surrounding reproductive safety, the necessity for preconception washout periods, and conflicting signals regarding psychiatric adverse events. We conclude that while GLP-1RAs show therapeutic potential for PMOS, their clinical application requires further evidence, particularly regarding reproductive safety and psychiatric effects, and should be embedded within a multidisciplinary care model that integrates metabolic, psychological, and reproductive management.

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Links Between Hormones, Appetite, and Mental Health in Older Women and What This Means for GLP-1 Treatment

Abstract

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