PLOD1 and polycystic ovary syndrome: During the perimenopause, aberrant LH patterns were found with far more LH surges that appear to be non-ovulatory (Fig. 2) than were found in the pilot study in regular cycles.5 This may be related to the ovaries having lower sensitivity to LH, akin to the postpartum amenorrheic period, but in this case due to lower ovarian egg reserve and potential impaired follicular development.16,17 It may be that gonadotropin-releasing hormone pulse frequency may lead to higher LH levels, as has been shown in the case of polycystic ovarian syndrome, which also leads to abnormal LH patterns.18