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Review
. 2024 Jan 16:14:1266806.
doi: 10.3389/fendo.2023.1266806. eCollection 2023.

The potential role of the orexin system in premenstrual syndrome

Ping Dong  1 , Weibo Dai  2 , Mengyue Su  3 , Shukun Wang  3 , Yuexiang Ma  1 , Tingting Zhao  4 , Feng Zheng  5 , Peng Sun  6
Affiliations
Review

The potential role of the orexin system in premenstrual syndrome

Ping Dong et al. Front Endocrinol (Lausanne). .

Abstract

Premenstrual syndrome (PMS) occurs recurrently during the luteal phase of a woman's menstrual cycle and disappears after menstruation ends. It is characterized by abnormal changes in both the body and mood, and in certain cases, severe disruptions in daily life and even suicidal tendencies. Current drugs for treating PMS, such as selective serotonin reuptake inhibitors, do not yield satisfactory results. Orexin, a neuropeptide produced in the lateral hypothalamus, is garnering attention in the treatment of neurological disorders and is believed to modulate the symptoms of PMS. This paper reviews the advancements in research on sleep disturbances, mood changes, and cognitive impairment caused by PMS, and suggests potential pathways for orexin to address these symptoms. Furthermore, it delves into the role of orexin in the molecular mechanisms underlying PMS. Orexin regulates steroid hormones, and the cyclic fluctuations of estrogen and progesterone play a crucial role in the pathogenesis of PMS. Additionally, orexin also modulates the gamma-aminobutyric acid (GABA) system and the inflammatory response involved in coordinating the mechanism of PMS. Unraveling the role of orexin in the pathogenesis of PMS will not only aid in understanding the etiology of PMS but also hold implications for orexin as a novel target for treating PMS.

Keywords: mechanism; new target; orexin; premenstrual syndrome; symptoms.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms associated with premenstrual syndrome. In animals and humans, ovarian hormone disruption, elevated inflammatory factors, and neurotransmitter imbalance are associated with the development of premenstrual syndrome.
Figure 2
Figure 2
Orexin may have a potential therapeutic effect on PMS symptoms by reducing daytime sleepiness and increasing the duration of rapid eye movement sleep, improving cognitive function, and alleviating depressive mood. Mechanistically, orexin can modulate ovarian hormones, suppress elevated levels of inflammatory factors, and increase the release of GABA neurotransmitters, all of which may contribute to its positive effect on PMS symptoms.
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Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Natural Science Foundation of China (NSFC, Nos. 81874419, 81673719, 82205290, and 81303074), National Health Commission of the People’s Republic of China (No. 2017ZX09301064 and 2017ZX09301064002), Natural Science Foundation of Shandong Province (Nos. ZR2020MB108 and ZR2019MH063), Central Government Guided Local Science and Technology Development Project (22-1-3-11-zyyd-nsh-3), Shandong Major Innovation Project (2022CXGC020514), Shandong Province Integrated Traditional Chinese and Western Medicine. Depression Prevention and Treatment Project (NO.YXH2019ZXY006) and the Youth Research and Innovation Team of TCM-Based Neuroimmune Pharmacology, University of Shandong Traditional Chinese Medicine (No. 22202112).