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This is why: Women with hypothalamic amenorrhea (often from low body weight or overtraining) see LH and FSH drop even with anatomically normal ovaries Women with insulin resistance linked to PMOS often have concurrent LH dysregulation Women under chronic psychological or physiological stress experience cycle irregularities even without apparent structural causes Addressing metabolic health is therefore not a "nice to have" alongside reproductive treatment it is often foundational to whether reproductive hormone signaling can normalize at all

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