Allopregnanolone in the pathogenesis of the psychiatric comorbidities of polycystic ovarian syndrome

Abstract

Polycystic ovarian syndrome (PCOS) is an endocrine disorder affecting 10–15 % of women of reproductive age, with significant implications for both physical and mental health. Several recent research studies have examined the connection between PCOS and psychiatric disorders; however, the mechanism linking the two is not fully understood. Allopregnanolone is a neurosteroid that modulates GABA_A receptors and is naturally affected by the pathophysiology of PCOS. It is thought to play a role in mood disorders, including premenstrual dysphoric disorder and postpartum depression. Recent research has begun to focus on the relationship between PCOS and allopregnanolone. A literature review was conducted using databases, including PubMed, MEDLINE, and Cochrane Library. Keywords included “PCOS,” “psychiatric disorders,” “allopregnanolone,” and “neurosteroids.” Articles were selected based on relevance to psychiatric implications of PCOS, with a focus on high-quality, original research studies. Quality assessment of the sources was informed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Handbook criteria. The literature review revealed a growing body of evidence suggesting a strong association between PCOS and an increased risk of psychiatric disorders, particularly depression, anxiety, and mood disorders. The role of allopregnanolone, a neurosteroid, was identified as an important factor in this relationship, with some studies indicating its potential impact on mood regulation in PCOS patients. There is a dire need for clinicians to consider the mental health implications of PCOS during diagnosis and management. The integration of psychiatric screening in PCOS management could lead to earlier detection and improved outcomes. Future research should focus on the therapeutic potential of allopregnanolone and other neurosteroids in treating psychiatric disorders associated with PCOS.