Neuroendocrine Crosstalk Between Sleep and Ovarian Function: Insights Into Hormonal Homeostasis

In humans, the sleep-reproductive endocrinology interface is likely overly conserved due to the neuroendocrine regulation of circadian rhythms, pulsatile hormonogenesis, and ovarian physiology. This review explores the bidirectional relationship between sleep architecture and the hypothalamic-pituitary-ovarian axis, emphasizing how circadian timing, sleep-wake patterns, and melatonin release influence the pulsatile secretion of gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone, and ovarian steroidogenesis. Sleep disturbances, such as insomnia, obstructive sleep apnoea, and circadian misalignment, can disrupt follicular development, ovulation, and menstrual regularity, all associated with subfecundity and endocrine disorders like polycystic ovary syndrome and endometriosis. Melatonin, with its antioxidant and chronobiotic properties, appears central to reproductive timing and the synchronization of light-dark cycles. This neuroendocrine interaction evolves across key sexual milestones (puberty, pregnancy, menopause) and is influenced by age and chronotype. Emerging neural imaging tools, biomarker assays, and chronotherapy studies now offer potential for personalized treatments that normalize melatonin levels. When combined with cognitive behavioral therapy for insomnia, such approaches may help restore hormonal balance and optimize reproductive outcomes. Sleep health should be integrated into reproductive medicine, requiring a holistic approach that incorporates circadian biology, stress responses, and environmental influences to support hormone regulation and women’s health across the lifespan.