Ovarian aging in women with diabetes: An overview
Open accessAbstract
Type 2 diabetes is a global epidemic, and the prevalence and incidence of type 1 diabetes are increasing. The negative effects of diabetes on kidneys, nerves, and vessels are well established. The effect of diabetes on reproductive function is less well understood, but important to characterize, given the increasing numbers of young women with diabetes. In this review, we summarize the available literature on how women with diabetes experience ovarian aging, from menarche to menopause. We report that women with type 1 diabetes appear more likely to have ovarian dysfunction, manifested by delayed menses, menstrual irregularities, and possibly earlier menopause. Studies of women with type 2 diabetes are inconsistent but suggest increased anovulation and earlier menopause. Differences in reproductive aging between women with type 1 and type 2 diabetes raise questions about potential differences in the mechanisms contributing to ovarian aging. Although there is shared glycemic dysregulation, fundamental differences in insulin presence and processing distinguish the two diseases. This review suggests that insulin, age at diagnosis, and weight play a role in ovarian dysfunction. More long-term studies are needed to evaluate the multitude of factors that may disrupt hypothalamic, pituitary, and ovarian function in women with diabetes.
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Men with type 1 diabetes may have impaired sperm mitochondrial function and epididymal dysfunction.
“There may be impaired sperm mitochondrial function in men with T1D and epidydimal dysfunction.1546,1552”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1546]
The Type 1 Diabetes Mellitus discussion and Conclusion address ovarian aging and reproductive function in women, not sperm or epididymal function in men. Searches for sperm mitochondrial function and epididymal dysfunction found no passage addressing either claim in this paper. (LLM, conf=0.77)
Experimental — accuracy not yet measuredMen with type 1 diabetes have fewer offspring.
“and a reduced number of offspring (T1D). 1545–1548”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1546]
The Type 1 Diabetes Mellitus section discusses menstrual irregularities and reproductive years in women, not the number of offspring fathered by men. Searches for men with type 1 diabetes and for “number of offspring” found no passage addressing the claim; page numbers were not available in our copy. (LLM, conf=0.77)
Experimental — accuracy not yet measuredDiabetes is associated with worse sperm quality, including lower concentration, progressive motility, and morphology.
“DM is associated with worsened sperm quality including decreased concentration, progressive motility, and sperm morphology.1546”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1546]
The Conclusion discusses ovarian function and reproductive aging in women with diabetes, not sperm quality. Searches for sperm concentration, progressive motility, morphology, and male fertility found no passage addressing the claim in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measuredMen with type 1 or type 2 diabetes have higher infertility rates.
“Men with DM (T1D or T2D) have higher rates of infertility”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1546]
The Results/Discussion sections on type 1 and type 2 diabetes discuss reproductive function in women, including menstrual irregularities and ovarian reserve. Searches for male infertility and infertility in men with either diabetes type found no passage addressing the claimed higher rates. (LLM, conf=0.76)
Experimental — accuracy not yet measuredSemen analysis in men with type 2 diabetes can show increased oxidative stress.
“For men with T2D, semen analysis can display findings of increased oxidative stress.1546”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1546]
The Results/Discussion section on T2DM discusses ovarian morphology and reserve in women, not semen findings in men. Searches for semen analysis, oxidative stress, and sperm or male reproductive findings found no passage addressing the claim in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Lowering insulin mitigates female reproductive aging and diet-induced ovarian dysfunctionPreprint
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“Considering that altered metabolic health is associated with changes to menopause timing (Mehra et al. 2023; Wellons et al. 2017; Sekhar et al. 2015), we chose to explore whether hyperinsulinemia itself— which can lie mechanistically upstream of obesity and other components of metabolic…”
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- Authors
- Wellons, M. F., Matthews, J. J., & Kim, C.
- Affiliations
- Vanderbilt University Medical Center (US)
- University of Michigan (US)
- Corresponding author
- Wellons, Melissa F.
- ORCID
- Kim, Catherine
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 96
- Pages
- 109-113
- ISSN
- 0378-5122 (ISSN-L)
- PMC
- PMC5268844
- OpenAlex
- W2557522235
- Cited by
- 49
- References
- 46
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 8 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R03HL135453)
- National Institute of Diabetes and Digestive and Kidney Diseases (DP3DK098129, P30DK092926)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- ovarian aging, diabetes mellitus, type 1 diabetes, type 2 diabetes, ovarian dysfunction, menopause, menstrual irregularity, anovulation, reproductive aging, insulin, age at diagnosis, body weight, hypothalamic-pituitary-ovarian axis
- MeSH terms
- Aging, Blood Glucose, Body Weight, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Insulin, Menopause, Menstruation Disturbances, Ovarian Diseases, Ovary, Age of Onset, Reproductive Health
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