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10.1126/science.1096096 380 WeiS.ZhengY.JiangY.LiX.GengJ.ShenY.et al (2019)

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This low-grade systemic inflammation: Impairs insulin receptor signalling, directly worsening insulin resistance Damages ovarian granulosa cells, impairing egg development and ovarian function Disrupts gut barrier integrity, contributing to what some researchers call a "leaky gut" pattern associated with systemic inflammation Amplifies HPA axis dysregulation, raising cortisol and further disrupting sex hormone balance Chronic inflammation is both a consequence of PMOS and a driver that perpetuates it