Abstract / Summary
Background: Obesity is a major global public health concern closely linked to the development and progression of various gynaecological disorders, particularly polycystic ovary syndrome (PCOS) and endometrial cancer. Incretins, a group of gut-derived hormones primarily including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are widely recognised for their roles in glycemic control and insulin secretion. Accumulating evidence reveals that GLP-1 and GIP also participate in modulating inflammation, autophagy, immune response and gut-brain communication through multiple signalling pathways, thereby playing important roles in female reproductive disorders. This review provides a comprehensive overview of the mechanisms and therapeutic potential of incretins in gynaecological conditions.
Methods: We performed a comprehensive literature search across PubMed, Web of Science and Embase, covering studies published from January 1995 to July 2026. Search terms combined incretin-related keywords (GLP-1, GIP, GLP-1 receptor agonists) with gynaecological disease terms (polycystic ovary syndrome, endometriosis, endometrial cancer, ovarian cancer, intrauterine adhesion). We primarily included original research studies and authoritative reviews, and excluded meeting abstracts, case reports and non-English literature.
Results: GLP-1 receptor agonists (GLP-1 RAs) exert multi-faceted benefits in PCOS, endometriosis, intrauterine adhesions and gynaecologic cancers through cAMP/PKA, PI3K and AMPK signalling pathways. Special emphasis is placed on the multi-faceted benefits of GLP-1 RAs, while evidence supporting GIP-based therapies in gynaecology remains relatively limited and largely preclinical. The current status of clinical application, safety considerations and future directions are further discussed.
Conclusion: Incretin-based therapies offer novel approaches for metabolic and oncological gynaecological diseases, with significant translational value. Large-scale clinical studies and deeper mechanistic exploration are warranted to realise their full therapeutic potential.