Research progress in the impact of elevated follicle-stimulating hormone levels on metabolic changes in postmenopausal women

doi:10.3969/j.issn.1674-8115.2026.07.018

Abstract

Abstract:

The hypothalamic-pituitary-ovarian axis (HPO) is the core endocrine system regulating the female menstrual cycle. The components of the HPO operate within a complex hormonal regulatory network to maintain reproductive health. Follicle-stimulating hormone (FSH), secreted by the pituitary gland, is essential for follicular development and steroidogenesis, whereas estrogen provides negative feedback to the hypothalamus and pituitary to preserve the dynamic balance of the HPO. With the onset of menopause, ovarian failure leads to a marked decline in estrogen levels, weakening this feedback loop and resulting in sustained elevations of circulating FSH. Accumulating evidence indicates that high FSH levels in postmenopausal women have effects extending beyond the reproductive system, acting through the follicle-stimulating hormone receptor (FSHR) expressed in adipose tissue, pancreatic islets, and bone to participate in energy metabolic remodeling and the regulation of metabolic homeostasis. Current findings suggest that elevated FSH is associated with lipid metabolic disturbances, adipose tissue inflammation, and an increased risk of cardiovascular disease. In glucose metabolism, FSH acts through FSHR expressed on pancreatic β cells to inhibit glucose-stimulated insulin secretion (GSIS), ultimately leading to impaired glucose homeostasis. In bone metabolism, FSH directly enhances osteoclast activity and promotes bone resorption, with part of this effect being independent of estrogen deficiency. This review summarizes advances in understanding the roles of elevated FSH levels in lipid, glucose, and bone metabolism in postmenopausal women and highlights the potential clinical implications and remaining challenges in this field.

Key words: hypothalamic-pituitary-ovarian axis (HPO), follicle-stimulating hormone (FSH), follicle-stimulating hormone receptor (FSHR), lipid metabolism, glucose metabolism, bone metabolism

CLC Number:

R711

Lin Xuefeng, Lai Dongmei. Research progress in the impact of elevated follicle-stimulating hormone levels on metabolic changes in postmenopausal women[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(7): 990-996.

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