Figure 1.

Association between elevated psychological stress and diminished ovarian function. Mental stress triggers the interaction between the nervous and the endocrine system, leading to metabolic disorder. These elements interact with each other, creating a NEM network that results in impaired ovarian function; feelings of shame caused by ovarian insufficiency further exacerbate the psychological burden, ultimately establishing a harmful loop of psychological stress and ovarian dysfunction. Figure generated by using BioRender.com. NEM, neuroendocrine-metabolic; HPA, hypothalamic-pituitary-adrenal; SAM, sympathetic-adrenal-medullary.