Polycystic ovarian syndrome is a common disorder characterised by ovulatory dysfunction and hyperandrogenaemia. Its origins begin peripubertally, as adolescent hyperandrogenaemia commonly leads to adult hyperandrogenaemia and decreased fertility. Hyperandrogenaemia reduces the inhibition of gonadotropin-releasing hormone pulse frequency by progesterone, causing rapid luteinising hormone pulse secretion and further increasing ovarian androgen production. Obese girls are at risk for hyperandrogenaemia and develop increased luteinising hormone pulse frequency with elevated mean luteinising hormone by late puberty. Many girls with hyperandrogenaemia do not exhibit normal luteinising hormone pulse sensitivity to progesterone inhibition. Thus, hyperandrogenaemia may adversely affect luteinising hormone pulse regulation during pubertal maturation, leading to persistent hyperandrogenaemia.

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