Reproductive Health and Brain Function: An Integrative Review of the Neurological Burden of Common Gynaecological Conditions

Background: Women’s reproductive health conditions such as endometriosis, menopause, and polycystic ovary syndrome (PCOS)—along with related disorders like restless legs syndrome (RLS) and bladder dysfunction—are traditionally viewed through a gynaecological lens. However, growing evidence demonstrates their substantial neurological and cognitive consequences, which remain under-recognised in clinical practice and policy. This integrative review explores the interplay between reproductive health conditions and brain function across the female life course, focusing on shared mechanisms, clinical manifestations, and implications for healthcare and policy. Methods: A comprehensive review of peer-reviewed literature, guidelines, and grey literature was undertaken to synthesise evidence on the neurological, cognitive, and psychosocial impacts of common reproductive health conditions. Evidence was mapped to a life-course and biopsychosocial framework. Results: Shared mechanisms included hormonal fluctuations, neuroinflammation, central sensitisation, and neuroendocrine disruption, all of which influence cognition, mood, and quality of life. Endometriosis was identified as a central pain syndrome with structural and functional brain alterations, psychiatric comorbidity, and associations with RLS. Menopause, driven by oestrogen withdrawal, was linked to “brain fog,” sleep disturbance, mood instability, and increased dementia risk. PCOS contributed to neurocognitive impairment through androgen excess, hypothalamic–pituitary–ovarian dysfunction, and metabolic abnormalities, increasing risks of depression, anxiety, and cognitive decline. Bladder dysfunction reflected wider neural network disruption and further compromised well-being. Conclusion: Despite their high prevalence, these conditions are underdiagnosed, poorly integrated into neurology and mental health care, and worsened by cultural stigma and systemic inequalities, especially in low- and middle-income countries. Urgent need exists for routine neurocognitive assessments, interdisciplinary care, and gender-sensitive policies. Recognising the brain–body interface and adopting a life-course, biopsychosocial perspective are key to advancing clinical practice, research, and global health equity for women.