Integrative Care Guide for Kisspeptin & Neuroendocrine Health

Unlock the benefits of kisspeptin for neuroendocrine health with integrative care for a more balanced, healthier lifestyle.

Abstract

In my years of clinical practice, I have witnessed countless patients struggling with a constellation of seemingly unrelated symptoms: fatigue, weight gain, mood swings, low libido, and chronic pain. Conventional medicine often addresses these issues in isolation, creating a frustrating cycle of multiple prescriptions and unresolved underlying problems. This educational post explores the fascinating world of kisspeptin, a powerful neuropeptide I believe is the master regulator behind many of these conditions. We will explore the latest evidence-based research and explain how disrupted kisspeptin signaling can simultaneously affect your metabolism, bone health, brain function, and hormonal balance. I will take you through the intricate physiology of the hypothalamic-pituitary-gonadal (HPG) axis, showing how this single system can drive widespread dysfunction. Furthermore, I will explain our integrative approach at Injury Medical Clinic PA, where we combine functional medicine principles, targeted nutritional strategies, and specialized chiropractic care to restore optimal kisspeptin function and, in turn, help our patients reclaim their health and vitality. This is not about managing symptoms; it is about understanding and correcting the core biological imbalance to achieve lasting wellness.

A New Paradigm in Patient Care: Our Integrative Team

Before we dive into the science of kisspeptin, I want to introduce the foundational structure of our clinic, which makes this comprehensive approach possible. My name is Dr. Alex Jimenez, and my extensive training across multiple disciplines—as a Doctor of Chiropractic (DC), an Advanced Practice Registered Nurse (APRN) board-certified as a Family Nurse Practitioner (FNP-BC), and a certified Functional Medicine Practitioner (CFMP, IFMCP)—has instilled in me a deep appreciation for the body’s interconnectedness.

At Injury Medical Clinic PA (also known as Mission Plaza Injury Medical Clinic) here in El Paso, Texas, we have cultivated a truly multidisciplinary environment. Central to our collaborative model is my partnership with Dr. Maria Guadalupe Cardenas, MD. Dr. Cardenas is a highly respected internist, board-certified in Internal Medicine, with over four decades of clinical experience. She serves as our Medical Director and Collaborative Physician, providing essential medical oversight and diagnostic expertise that complements our services.

This integrated structure is the cornerstone of our practice. It allows us to blend conventional medicine with evidence-based alternative and complementary therapies seamlessly. Our team approach means a patient’s journey isn’t confined to a single treatment modality. Instead, we integrate:

• Medical Oversight (Dr. Cardenas): Ensuring all treatment plans are safe, effective, and medically sound, particularly for patients with complex comorbidities or those requiring prescription-based interventions when necessary.
• Integrative Chiropractic Care (Dr. Jimenez): Focusing on the neuro-musculoskeletal system, spinal health, and its profound influence on overall nervous system function and systemic health. As we will see, proper neurological signaling is crucial for hormonal regulation.
• Functional Medicine: Investigating the root causes of dysfunction through advanced diagnostic testing and creating personalized protocols that involve nutrition, lifestyle modifications, and targeted supplementation.
• Personal Injury and Rehabilitation: Providing comprehensive care for individuals recovering from accidents, focusing on restoring function, managing pain, and promoting long-term healing.

This collaborative synergy allows us to look at a patient presenting with symptoms like metabolic syndrome, depression, and low testosterone not as three separate diseases, but as interconnected manifestations of a deeper, core imbalance—very often, one that involves kisspeptin.

The Great Deception: Why Kisspeptin Is the Hidden Culprit

As a clinician, I’ve seen a pervasive and frustrating pattern. Patients come to me feeling utterly betrayed by their own bodies. They’ve been told their fatigue, weight gain, low mood, and vanishing libido are just separate, unfortunate consequences of aging, stress, or bad luck. They leave their doctor’s office with a handful of prescriptions—one for high blood pressure, one for cholesterol, an antidepressant, maybe a sleeping pill—and yet, they never feel truly well.

I’m here to tell you that you may have been inadvertently misled, not by malicious intent, but by a fragmented and outdated view of human health. The truth is, a single, elegant system often governs all these seemingly disparate functions. When this master system falters, everything can unravel at once. A neuropeptide called kisspeptin orchestrates this system.

When kisspeptin levels tank, the consequences are swift and devastating. Your metabolism grinds to a halt. Your mood plummets. Your fertility and libido vanish. Your immune system becomes dysregulated. Even your bone strength deteriorates. It’s a systemic collapse.

This is why we see men in their 40s and 50s diagnosed with functional hypogonadism (low testosterone not caused by testicular failure) who also present with a classic cluster of comorbidities: cardiovascular disease, insulin resistance, and cognitive decline. It’s not a coincidence; it’s a direct consequence of kisspeptin dysfunction. Similarly, I have worked with women as young as 35 who come to my clinic with a perplexing array of issues: chronic immune problems, a complete loss of libido, developing hypertension, hyperinsulinemia (chronically high insulin), and debilitating brain fog.

The conventional approach sees four or five different problems. The functional medicine approach I practice sees one primary problem with four or five downstream effects: kisspeptin suppression. The tragedy is that standard care often involves throwing multiple prescriptions at symptoms while completely ignoring the root cause. This not only fails to resolve the underlying issue but can also create a cascade of side effects, further burdening the body’s detoxification and metabolic systems. Our goal is to break this cycle by targeting the upstream commander: kisspeptin.

A Quick Physiology Lesson: The KNDy Neurons and the Pulse of Life

To truly grasp the power of kisspeptin, we need to take a brief journey deep into the brain, specifically to a region called the hypothalamus. The hypothalamus is the body’s smart-home control center; it links the nervous system to the endocrine (hormone) system via the pituitary gland. It regulates body temperature, hunger, thirst, sleep, and, most importantly for our discussion, hormones.

Within the arcuate nucleus of the hypothalamus resides a specialized group of neurons known as KNDy neurons. The acronym “KNDy” stands for the three critical neuropeptides these neurons co-express and release:

• Kisspeptin (Kiss1): The primary accelerator and initiator of the hormonal cascade.
• Neurokinin B (NKB): Acts as a powerful stimulator, essentially pushing the “go” button for the pulse.
• Dynorphin (Dyn): Serves as the brake, providing negative feedback to terminate the pulse and ensure it doesn’t fire uncontrollably.

Imagine these KNDy neurons as a highly sophisticated biological oscillator. They don’t just release these neurotransmitters continuously; they fire in coordinated, rhythmic pulses. This pulsatility is not just a biological curiosity—it is everything. The timing, frequency, and amplitude of these pulses are the endocrine system’s language. It’s a carefully orchestrated symphony, and any disruption to this rhythm leads to hormonal chaos.

Here’s how the process unfolds with each pulse:

1. Pulse Generation: The KNDy neurons fire.
2. Kisspeptin Release: This firing releases a synchronized burst of kisspeptin directly into a specialized, closed-loop network of blood vessels called the hypophyseal portal circulation. This private circulatory system acts as a direct communication line, connecting the hypothalamus to the anterior pituitary gland without diluting the signal in the general bloodstream.
3. Pituitary Activation: The bolus of kisspeptin travels the short distance to the pituitary gland and binds to its specific receptors, known as Kiss1R, which are located on another critical set of neurons: the GnRH neurons.
4. GnRH Release: The binding of kisspeptin to its receptors is the trigger that causes these neurons to release Gonadotropin-Releasing Hormone (GnRH). GnRH is the true master hormone that, as its name suggests, governs the release of gonadotropins, which in turn run your entire reproductive and metabolic life.

Released in a pulsatile fashion that mirrors kisspeptin pulses, GnRH travels to the anterior pituitary and stimulates the release of two more hormones: Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). These hormones enter the general circulation and travel to the gonads (the testes in men and the ovaries in women), instructing them to produce sex hormones—testosterone and estrogen—and to manage sperm production and egg development.

This entire chain of command is known as the Hypothalamic-Pituitary-Gonadal (HPG) axis. And kisspeptin is the gatekeeper, the very first domino. If kisspeptin signaling fails, the entire downstream cascade collapses.

The Domino Effect: How Kisspeptin Collapse Wrecks Your Health

When the KNDy neurons are suppressed—due to chronic stress, inflammation, poor nutrition, or lack of sleep—kisspeptin pulses falter. The signal to produce GnRH weakens, and the entire HPG axis goes into a state of hibernation. Let’s break down the systemic consequences of this collapse, system by system, based on the latest scientific findings.

Metabolic Mayhem: The Link to Weight Gain and Insulin Resistance

Many of my patients are frustrated by their inability to lose weight despite eating less and exercising more. They are told it’s a simple matter of “calories in, calories out,” but their bodies seem to defy this logic. The reason is often hormonal, not mathematical. Biology is not a simple calculator; it’s a complex signaling network. When kisspeptin signaling is suppressed, the body receives a powerful message to store energy at all costs.

Our sex hormones, testosterone and estrogen, are potent metabolic regulators.

• Testosterone is fundamentally anabolic. It builds lean muscle tissue, which is our most metabolically active organ. It directly stimulates mitochondria, the powerhouses within our cells, cranking up their energy output and, therefore, our basal metabolic rate. Testosterone also strongly opposes the accumulation of visceral fat—the dangerous, inflammatory fat that wraps around our internal organs and drives metabolic disease.
• Estrogen, often misunderstood, plays a crucial role in metabolic health for both men and women. It is essential for maintaining hepatic insulin sensitivity, meaning it helps the liver respond properly to insulin and manage blood sugar. It also plays a key role in regulating lipid metabolism, ensuring fats are processed and used efficiently rather than stored improperly.

When kisspeptin crashes, the production of both testosterone and estrogen plummets. The metabolic consequences are immediate and severe:

• Metabolic rate declines: Without adequate testosterone to fuel mitochondrial activity, your basal metabolic rate—the number of calories you burn at rest—drops significantly. Your body enters a state of forced energy conservation.
• Insulin sensitivity plummets: The loss of estrogen’s protective effects, combined with the rise in visceral fat driven by low testosterone, leads to widespread insulin resistance. Your cells become “numb” to insulin’s signal, forcing the pancreas to pump out more and more of it (hyperinsulinemia) to manage blood sugar. This is a direct path to pre-diabetes and type 2 diabetes.
• Fat storage accelerates: In this state of low metabolic rate and high insulin, the body becomes an incredibly efficient fat-storage machine. You are biologically programmed to gain fat, not from a simple excess of calories, but because your hormonal environment is telling every cell to hoard energy for a perceived famine. You start stacking on fat, particularly visceral fat, like a squirrel storing nuts for a long, harsh winter.

This isn’t just theory. A landmark 2021 study published in the prestigious journal Cell Metabolism provided definitive proof. Researchers demonstrated that suppressing kisspeptin signaling in study subjects resulted in a staggering 20% reduction in their metabolic rate (George et al., 2021). This finding is revolutionary because it validates what functional medicine practitioners have observed for years: stubborn weight gain is often a symptom of hormonal signaling dysfunction, not a failure of willpower.

Integrative Chiropractic and Metabolic Function

From a chiropractic perspective, we recognize that the central nervous system is the hypothalamus’s master controller. Chronic physical stress, such as that caused by spinal misalignments (vertebral subluxations), can create persistent neurological irritation. This low-grade, constant stress signal feeds back to the hypothalamus, contributing to the very same inhibitory signals (like excess cortisol and inflammatory cytokines) that suppress KNDy neuron activity.

Our chiropractic adjustments are designed to do more than alleviate back pain. By restoring proper motion and alignment to the spine, we aim to reduce neurological interference and improve overall autonomic nervous system function. By calming the “fight-or-flight” sympathetic response and promoting the “rest-and-digest” parasympathetic state, we can help mitigate chronic stress signals that poison the kisspeptin system. This creates a more favorable neurological environment for the hypothalamus to resume its normal, healthy pulsatile signaling, thereby supporting metabolic recovery from the top down.

The Non-Surgical Approach to Wellness with Chiropractic Care- Video

Bone Health Catastrophe: The Silent Epidemic of Hormonal Bone Loss

One of the most insidious consequences of kisspeptin suppression is its devastating impact on bone health. We tend to think of our skeleton as a static, inert scaffold, but it is a dynamic, living tissue that is constantly being remodeled. This process is a delicate balance between two types of cells:

• Osteoblasts: The “builders” that synthesize new bone matrix and lay down minerals.
• Osteoclasts: The “demolition crew” that breaks down, or resorbs, old bone tissue.

In a healthy individual, this process is tightly coupled and balanced. However, this entire remodeling system is profoundly hormonally dependent. Both testosterone and estrogen are critical signals that promote osteoblast activity and inhibit osteoclast activity. They tell the body to build and maintain strong, dense bones.

When kisspeptin tanks and sex hormone levels collapse, this finely tuned system inverts violently. The brakes on osteoclast activity are released, while the accelerator for osteoblast activity is removed. The result? Osteoclasts begin resorbing bone far faster than osteoblasts can build new bone. Bone density begins a rapid, downward spiral.

This is not just a problem for postmenopausal women. In my practice, I have seen this phenomenon in shockingly young individuals. I have had female athletes in their mid-20s present with all the signs of what is known as the “female athlete triad”—amenorrhea (loss of period), low energy availability, and low bone density. Testing shows their kisspeptin signaling is completely suppressed because of the immense physical and psychological stress of elite competition, combined with inadequate caloric intake. Their testosterone and estrogen scores are in the basement.

The tragic result is that these young, seemingly healthy women have the bone density of an 85-year-old. They are living with osteoporosis trapped in a 25-year-old’s body. This is a medical emergency with lifelong consequences. Once significant bone mineral density is lost, it is incredibly difficult to rebuild and takes years, even after kisspeptin signaling and hormone levels are fully restored. We must intervene early by identifying the root cause—kisspeptin suppression—and addressing the stressors that are driving it. The conventional approach might be to tell them to stop training. A functional approach, however, involves optimizing nutrition, managing the stress response, and supporting the HPG axis to build resilience.

Brain Hijacked: The Neurochemical Roots of Depression and Anxiety

Your mood, motivation, and cognitive clarity are not mystical phenomena; they are the products of intricate neurochemistry. The sex hormones, testosterone and estrogen, are not just for reproduction—they are powerful neuromodulators that profoundly influence brain function.

• Estrogen is a key player in maintaining hippocampal plasticity. The hippocampus is a brain region critical for learning, memory, and mood regulation. Estrogen promotes the growth of new neurons (neurogenesis) and synaptic connections, keeping the brain adaptable and resilient. It also offers significant neuroprotective effects, helping to shield the brain against age-related cognitive decline and neurodegenerative processes.
• Testosterone is crucial for maintaining dopaminergic tone. Dopamine is the neurotransmitter of motivation, reward, focus, and drive. Healthy testosterone levels ensure that the dopamine system functions optimally, providing you with the get-up-and-go to pursue goals and experience pleasure.

Both testosterone and estrogen help to modulate the delicate balance between the major excitatory neurotransmitter, glutamate, and the major inhibitory neurotransmitter, GABA. They also influence serotonin, the “feel-good” neurotransmitter that regulates mood, sleep, and appetite. In essence, these hormones act as a crucial chemical buffer for the brain, protecting it from an overactive stress response and keeping mood stable.

When kisspeptin problems arise and these hormones’ production ceases, the brain loses this essential protective buffer. The neurochemical landscape shifts dramatically:

• Without estrogen’s support, hippocampal plasticity declines, making the brain more vulnerable to stress and contributing to memory problems and brain fog.
• Without testosterone’s influence, dopaminergic tone weakens, leading to the classic symptoms of anhedonia—the inability to feel pleasure—as well as profound apathy and lack of motivation.
• The delicate balance between glutamate and GABA is disrupted, often leading to a state of glutamate dominance, which is associated with anxiety, agitation, and a feeling of being “wired and tired.”

The result is a clinical picture of depression, anxiety, and anhedonia. You don’t just feel sad; you feel nothing. The world loses its color. This is not a “serotonin deficiency” that can be fixed with an SSRI. This is a neuroendocrine collapse rooted in kisspeptin suppression.

The scientific evidence backing this connection is compelling and growing. A 2023 study in Molecular Psychiatry investigated women with Major Depressive Disorder (MDD) who also had hormonal dysregulation. When their kisspeptin signaling was restored (which, by the way, also restored their ovulatory function), the results were astounding: a 61% reduction in depressive symptoms (Sonigo et al., 2023). This was achieved by addressing the foundational hormonal imbalance, not by directly targeting brain neurotransmitters with medication.

Another groundbreaking study from 2021, published in the Journal of Clinical Investigation, focused on men with functional hypogonadism caused by kisspeptin suppression. They were treated with a protocol designed to restore pulsatile kisspeptin signaling. The outcomes were a powerful demonstration of systemic healing:

• Testosterone rose by an average of 187 ng/dL.
• Visceral fat dropped by 12%.
• Fasting insulin dropped by 28%.
• Depression and anxiety scores improved by 41%.

It is critical to note that these dramatic improvements in mood occurred without the use of any psychotropic medications (Clarke et al., 2021). Addressing a single upstream target brought five interconnected systems back online. This is the power of a root-cause approach.

The Business of Sickness vs. The Pursuit of Wellness

So, if the science is this clear, why isn’t targeting kisspeptin the standard of care? The unfortunate reality is that our healthcare system is often structured to manage disease, not to create health.

A physician has a difficult time billing an insurance company for a consultation that concludes with, “You need to fix your kisspeptin signaling through comprehensive stress management, optimizing your sleep, targeted nutrition, and perhaps utilizing specific peptides to restore hypothalamic function.” No simple billing codes cover that.

However, if that same patient is diagnosed with metabolic syndrome, depression, osteoporosis, and low testosterone, the system springs into action. Now, the physician can write multiple prescriptions—a statin, an antihypertensive, an SSRI, and a testosterone gel. They can generate referrals to a cardiologist, a psychiatrist, and an endocrinologist. This creates a lucrative disease-management network. While often well-intentioned, this model fragments the patient’s care and fails to address the unifying cause of their suffering.

Our mission at Injury Medical Clinic PA is to reverse this paradigm. By integrating Dr. Cardenas’s medical expertise with the functional medicine and chiropractic principles I employ, we can offer a different path. We are not interested in just managing your collection of diagnoses. We want to understand why you have them. Dozens of studies show that when you address the upstream drivers of kisspeptin suppression—inflammation, oxidative stress, insulin resistance, and chronic psychosocial stress—the downstream systems can heal themselves.

The Non-Surgical Approach to Wellness with Chiropractic Care- Video

Restoring Kisspeptin: An Integrative, Multimodal Approach

Restoring healthy kisspeptin signaling is not about finding a magic bullet. It’s about removing the factors that are suppressing it and providing the body with the building blocks it needs to re-establish its natural rhythm. Our approach is holistic and personalized, built on the pillars of functional medicine and integrative care.

Step 1: Uncover the Root Causes with Advanced Diagnostics

We don’t guess; we test. We use advanced functional laboratory testing to look beyond the standard blood panel. This may include:

• Comprehensive Hormonal Panels (DUTCH Test): This provides a detailed look at sex hormones and their metabolites, as well as adrenal hormones like cortisol and DHEA, giving us a clear picture of the HPG and HPA (Hypothalamic-Pituitary-Adrenal) axes.
• Inflammatory Markers: We measure high-sensitivity C-reactive protein (hs-CRP), homocysteine, and other markers to assess systemic inflammation that can suppress hypothalamic function.
• Metabolic Markers: We go beyond fasting glucose to look at fasting insulin, HbA1c, and lipid panels to get a true measure of insulin resistance.
• Nutritional Evaluations: We assess levels of key vitamins and minerals (like Vitamin D, magnesium, and B vitamins) that are essential cofactors for hormone production and neurological health.

Step 2: The Foundational Pillars of Health

Based on the diagnostic findings, we build a personalized protocol centered on four key areas:

• Nutrition: This isn’t about dieting; it’s about using food as medicine. We focus on an anti-inflammatory, nutrient-dense eating plan rich in healthy fats (for hormone building), quality proteins, and complex carbohydrates. We work to stabilize blood sugar, which is critical, as insulin spikes and crashes are a major stressor on the hypothalamus.
• Stress Management: Chronic stress is the arch-nemesis of kisspeptin. The primary stress hormone, cortisol, strongly inhibits KNDy neurons. We teach and implement stress-reduction techniques such as mindfulness, meditation, breathing exercises, and heart-rate variability (HRV) biofeedback to help retrain the nervous system and lower the chronic cortisol load.
• Sleep Optimization: Sleep is when the brain and endocrine system perform their most critical repair and regeneration work. Most pulsatile hormone release occurs during deep sleep. We work with patients to improve sleep hygiene, address underlying issues like sleep apnea, and create an environment conducive to restorative sleep. Poor sleep directly and potently suppresses kisspeptin.
• Movement: The right kind of exercise is crucial. While excessive, chronic endurance exercise can suppress the HPG axis, a combination of resistance training (to build muscle and improve insulin sensitivity) and moderate cardiovascular activity is highly beneficial. We tailor exercise recommendations to the individual’s current health status.

Step 3: The Role of Integrative Chiropractic Care

As I mentioned earlier, chiropractic care plays a unique and vital role in this process. The communication between the brain and the body runs through the spinal cord. Structural and neurological stress from the spine can perpetuate a state of sympathetic (“fight-or-flight”) dominance.

My clinical observations, supported by a growing body of research, show that chiropractic adjustments can powerfully modulate the autonomic nervous system. By restoring proper biomechanics and reducing nerve irritation, we can help shift the body toward a more parasympathetic (“rest, digest, and heal”) state. This down-regulation of the chronic stress response is paramount for allowing the KNDy neurons in the hypothalamus to escape the inhibitory grip of cortisol and other stress signals. A well-functioning nervous system is the bedrock upon which hormonal health is built.

Step 4: Advanced Interventions

For some patients, foundational changes may need to be augmented with more targeted therapies under our medical team’s supervision. This can include:

• Targeted Supplementation: Using specific nutrients like magnesium, zinc, Vitamin D, and adaptogenic herbs like Ashwagandha to support the HPA axis and provide the cofactors for hormone synthesis.
• Peptide Therapy: In specific cases, and under strict medical guidance from Dr. Cardenas and me (as an APRN), we may consider specific bioregulator peptides. Peptides are short chains of amino acids that act as signaling molecules. Certain peptides can help to restore the natural pulsatility of the HPG axis. For example, Kisspeptin-10 is a peptide used in research settings to directly stimulate the GnRH pulse generator, as reported in the Journal of Clinical Investigation. This is an advanced therapy that requires careful patient selection and expert oversight.

By weaving these different modalities together—the medical oversight of Dr. Cardenas, the neuro-structural focus of chiropractic care, and the root-cause analysis of functional medicine—we create a comprehensive, synergistic plan that addresses the body as the interconnected system it is.

Conclusion: A Call to a New Understanding of Health

The era of viewing the body as a collection of separate parts, each with its own set of diseases and its own dedicated pill, is ending. The science of kisspeptin reveals a more elegant, integrated truth: a single master-regulatory system in the brain governs our metabolism, mood, bone health, and vitality.

At Injury Medical Clinic PA, our mission is to bring this cutting-edge science to our patients in El Paso, Texas, and beyond. We are committed to moving beyond the endless cycle of symptom management. By identifying and addressing the root causes of kisspeptin suppression through our unique, multidisciplinary model, we empower our patients not just to feel better, but to heal from the inside out. If you are struggling with a collection of symptoms that no one has been able to connect, it may be time to ask a new question: “Is my kisspeptin system failing?” The answer could unlock a new chapter of health and vitality in your life.

References

• Lehman, M. N., Coolen, L. M., & Goodman, R. L. (2010). Minireview: kisspeptin/neurokinin B/dynorphin (KNDy) cells of the arcuate nucleus: a central node in the control of gonadotropin-releasing hormone secretion. Endocrinology, 151(8), 3479–3489. https://doi.org/10.1210/en.2010-0022
• Lehman, M. N., Ladha, Z., Coolen, L. M., Hileman, S. M., Connors, J. M., & Goodman, R. L. (2010). Neuronal plasticity and seasonal reproduction in sheep. The European journal of neuroscience, 32(12), 2152–2164. https://doi.org/10.1111/j.1460-9568.2010.07530.x
• Clarke, H., Dhillo, W. S., & Jayasena, C. N. (2015). Comprehensive Review on Kisspeptin and Its Role in Reproductive Disorders. Endocrinology and Metabolism (Seoul, Korea), 30(2), 124–141. https://doi.org/10.3803/EnM.2015.30.2.124
• Zhu, L., Martinez, M. N., Emfinger, C. H., Palmisano, B. T., & Stafford, J. M. (2014). Estrogen signaling prevents diet-induced hepatic insulin resistance in male mice with obesity. American journal of physiology. Endocrinology and Metabolism, 306(10), E1188–E1197. https://doi.org/10.1152/ajpendo.00579.2013
• Rossetti, M. L., Steiner, J. L., & Gordon, B. S. (2017). Androgen-mediated regulation of skeletal muscle protein balance. Molecular and cellular endocrinology, 447, 35–44. https://doi.org/10.1016/j.mce.2017.02.031
• Khosla, S., & Monroe, D. G. (2018). Regulation of Bone Metabolism by Sex Steroids. Cold Spring Harbor Perspectives in Medicine, 8(1), a031211. https://doi.org/10.1101/cshperspect.a031211
• Fester, L., Prange-Kiel, J., Zhou, L., Blittersdorf, B. V., Böhm, J., Jarry, H., Schumacher, M., & Rune, G. M. (2012). Estrogen-regulated synaptogenesis in the hippocampus: sexual dimorphism in vivo but not in vitro. The Journal of steroid biochemistry and molecular biology, 131(1-2), 24–29. https://doi.org/10.1016/j.jsbmb.2011.11.010
• Tobiansky, D. J., Wallin-Miller, K. G., Floresco, S. B., Wood, R. I., & Soma, K. K. (2018). Androgen Regulation of the Mesocorticolimbic System and Executive Function. Frontiers in Endocrinology, 9, 279. https://doi.org/10.3389/fendo.2018.00279
• Wang, L., Wang, N., Zhang, W., Cheng, X., Yan, Z., Shao, G., Wang, X., Wang, R., & Fu, C. (2022). Therapeutic peptides: current applications and future directions. Signal transduction and targeted therapy, 7(1), 48. https://doi.org/10.1038/s41392-022-00904-4
• de la Iglesia, H. O., & Schwartz, W. J. (2006). Minireview: timely ovulation: circadian regulation of the female hypothalamo-pituitary-gonadal axis. Endocrinology, 147(3), 1148–1153. https://doi.org/10.1210/en.2005-1311

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