FAAH as a Molecular Regulator of Endocannabinoid Signaling: Mechanistic Insights into Reproductive, Metabolic, and Inflammatory Dysfunctions in Polycystic Ovary Syndrome

Fatty acid amide hydrolase (FAAH) is a critical metabolic enzyme in the endocannabinoid system. Through regulating the metabolism of lipid signaling molecules, FAAH is involved in a variety of physiological and pathological processes, including cell proliferation, inflammatory responses, and metabolic homeostasis. Polycystic ovary syndrome (PCOS), one of the most common endocrine and metabolic disorders affecting women of reproductive age, is closely associated with abnormal follicular development, dysregulated hormone secretion, insulin resistance, dyslipidemia, and inflammatory imbalance. Emerging evidence suggests that FAAH-mediated dysregulation of endocannabinoid metabolism is associated with the pathogenesis of PCOS through the modulation of inflammatory pathways, insulin sensitivity, and hormone secretion. This review systematically summarizes the structure, biological functions, and regulatory mechanisms of FAAH, with particular emphasis on its roles in PCOS-associated pathological processes, including reproductive dysfunction, hormonal dysregulation, metabolic imbalance, and inflammatory responses. This review aims to provide a theoretical foundation for elucidating the molecular mechanisms underlying PCOS and for the development of novel therapeutic strategies.