Metabolic syndrome is an endocrine disorder that involves systemic alterations of intermediate metabolism, cardiovascular, hormonal, and reproductive systems. It is characterized by central obesity, elevated blood pressure, insulin resistance, and dyslipidemia, which lead to the development of type 2 diabetes mellitus, cardiovascular and renal diseases. At the clinical level, the central axis of patients with metabolic syndrome focuses on the prevention of cardiorenometabolic comorbidities, however, it's not common that the physician addresses the issue of male reproduction and its implications. Currently there is increasing evidence that patients with metabolic syndrome have low levels of testosterone, GnRH, FSH and LH and high levels of estrogen which impacts sperm quality, fertility, and sexual health, which can undoubtedly be reversible upon remission of the metabolic syndrome. This review addresses clinically how metabolic syndrome impacts the male reproductive system, addressing male fertility, testicular endocrine function, and sexual health.

Polycystic ovary syndrome (PCOS) is a heterogeneous, complex, and widely misunderstood endocrine disorder that affects intermediate metabolism, the cardiovascular and reproductive systems, and has social and psychological consequences. The prevalence and incidence of PCOS is high among women with Metabolic Syndrome (MetS). In Mexico, the hyperandrogenic subtype is the most prevalent of the characterized subtypes and is characterized by hyperandrogenism, insulin resistance, and ovulatory dysfunction. Central obesity plays a role in the development of the hyperandrogenic subtype as adipositopathy can cause a syndrome of insulin resistance and androgen excess, both of which contribute to cardiovascular comorbidities. These two syndromes share similar pathophysiological mechanisms, suggesting that PCOS could be a complication of MetS or vice versa. The purpose of this article is to explore the relationship between MetS and PCOS, with a focus on pathogenesis, infertility, microbiota, comorbidities, and treatment.