As type 2 diabetes mellitus (T2DM) reaches epidemic proportions in the developed world and the age at diagnosis decreases, more women of reproductive age are being affected. In this article, we provide a synoptic view on potential mechanisms and relevant factors underlying menstrual cycle disorders and fertility issues in women with T2DM. The article discusses the function of the hypothalamic-pituitary-ovarian (HPO) axis, the central role of the hypothalamus in the homeostasis of this system, the central modulators of the axis, and the peripheral metabolic signals involved in neuroendocrine control of reproduction. The available literature on the relationship between T2DM and the female reproductive lifespan, menstrual cycle disorders, fertility issues, and gestational health in women with T2DM are also discussed. The data so far indicate that there is a “U-shaped” relationship between menarche, menopause, and T2DM, both early and late menarche/menopause being risk factors for T2DM. Hyperglycemia and its consequences may be responsible for the effects of T2DM on reproductive health in women, but the exact mechanisms are not as yet fully understood; thus, more studies are needed in order to identify factors causing disruption of the HPO axis.

中文翻译：

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2型糖尿病女性的生殖健康。

随着发达国家中2型糖尿病（T2DM）的流行和诊断年龄的降低，越来越多的育龄妇女受到影响。在本文中，我们概述了T2DM女性月经周期失调和生育问题的潜在机制和相关因素。本文讨论了下丘脑-垂体-卵巢（HPO）轴的功能，下丘脑在该系统稳态中的核心作用，该轴的中央调节器以及与神经内分泌控制生殖有关的外周代谢信号。还讨论了有关T2DM与女性生殖寿命，月经周期失调，生育问题和妊娠健康之间关系的文献。迄今为止的数据表明，初潮，更年期和T2DM之间存在“ U型”关系，初潮和绝经的早期和晚期都是T2DM的危险因素。高血糖及其后果可能是T2DM对女性生殖健康的影响的原因，但确切的机制尚不完全清楚。因此，需要更多的研究来确定引起HPO轴破坏的因素。