Regulation of arcuate nucleus kisspeptin/neurokinin B and gonadotropin-releasing hormone during negative energy balance

Female reproductive function is tightly linked to metabolic status, requiring sufficient energy for fertility. Negative energy balance—caused by inadequate intake or excessive expenditure—triggers adaptive mechanisms to conserve energy, including suppression of ovarian cycling in adulthood and delayed puberty during development. These responses prevent the high metabolic costs of gestation and lactation and may involve both active inhibition and failure of permissive growth signals. Understanding how metabolic cues regulate reproduction has critical implications for women’s health and could inform therapeutic strategies for infertility associated with energy imbalance.