Neurogynaecology and Women’s Reproductive Health: A PRISMA Based Systematic Review of Neuroendocrine Regulation, Autonomic Dysfunction, Psychosomatic Stress, and Integrative Therapeutic Outcomes

Background Neurogynecology is a rapidly evolving interdisciplinary field that elucidates bidirectional interactions between the nervous system and the female reproductive system. Disorders including polycystic ovarian syndrome (PCOS), dysmenorrhea, endometriosis, chronic pelvic pain, and stress-related infertility are increasingly recognised as biopsychoneuroimmune conditions in which neuroendocrine dysregulation, autonomic imbalance, psychosomatic stress, and neuro-immune signaling function as central pathogenic mechanisms. Objectives To systematically synthesise evidence on neuro-gynaecological mechanisms, evaluate clinical correlations, and assess integrative therapeutic outcomes across key gynaecological conditions. Methods A PRISMA-guided systematic review was conducted. PubMed, Scopus, and Google Scholar were searched using predefined Boolean operators. Peer-reviewed clinical, observational, experimental, neuroimaging, and psychosomatic studies published primarily between 2000 and 2026 were included, for neurological, neuroendocrine, autonomic, or psychosomatic relevance to gynaecological pathology. Results Eighty-nine studies met inclusion criteria. Four principal neuro-gynaecological pathogenic domains were identified: (1) HPA–HPO axis dysregulation mediating stress-induced reproductive suppression; (2) autonomic nervous system imbalance characterised by sympathetic hyperactivity and reduced vagal tone, measurable by heart rate variability; (3) psychosomatic stress driving central sensitisation and disproportionate pain perception; and (4) bidirectional neuro-immune crosstalk sustaining neurogenic inflammation in chronic pelvic conditions. Conclusion Gynaecological disorders represent complex, centrally driven biopsychoneuroimmune conditions requiring multidimensional diagnostic and therapeutic frameworks. Adopting an integrative neuro-gynaecological model has significant potential to improve diagnostic precision, reduce symptom chronicity, and deliver personalised, patient-centered women's healthcare. Neurogynecology is positioned to become an essential and standard pillar of modern gynaecological practice.