Kisspeptin Neurons as Integrative Hub: Cross‐Talk of <scp>HPO</scp> – <scp>HPT</scp> – <scp>HPA</scp> Axes in Perimenopausal Reproductive Health

This study methodically examines the mechanisms of interaction of these neuroendocrine axes in perimenopausal women and their overall effects on their reproductive health. The results show that the dysfunction of the HPT axis is closely related to depression and anxiety, whereas HPA axis hyperactivity inhibits HPO axis functioning and results in reproductive dysfunction. Thyroid hormones indirectly control reproductive functioning through their regulation of the secretion of gonadotropin-releasing hormone and the decrease in estrogen levels worsens the inflammatory response and neuroendocrine dysregulation. This research findings the pathophysiological basis of perimenopausal endocrine disorders from the multi-axis interaction perspective, displaying the clinical translation potential of the kisspeptin neurons-targeting treatment and offering new avenues of individualized and multi-axis synergistic treatment.