Metabolic Control of Reproductive Function

Reproductive physiology is highly influenced by nutritional states. When survival is threatened by food scarcity or increased energy demands, males and females divert energy away from energy-demanding processes, including reproduction. Conversely, excess energy, as in obesity, also negatively impacts fertility. Increased adiposity exacerbates ovulatory dysfunction and polycystic ovary syndrome and may induce infertility in both sexes. If able to conceive, women with obesity face higher risks of poor pregnancy outcomes, and maternal and fetal morbidity and mortality.

Metabolic dysregulation also affects sexual maturation. Leanness delays puberty, while childhood obesity is associated with earlier puberty. Over the past three decades, earlier puberty has been consistently reported. Higher rates of childhood obesity are potential determinants for this trend, particularly in girls. Advanced puberty is linked to higher risks of adult obesity, diabetes, cardiovascular diseases, and cancer. This is alarming and highly relevant for human health, imposing profound health implications for future generations.

The presenter of the Clark T. Sawin Memorial History of Endocrinology Lecture is the recipient of the 2025 Delbert A. Fisher Research Scholar Award.