By contrast, the PCOM–STRESS subgroup illustrates how stress modifies the typical PCOS-like profile: hypothalamic inhibition selectively lowers LH, leading to reduced AMH and estradiol despite preserved ovarian morphology (Hager et al. 2023; Carmina et al. 2016; Beitl et al. 2022). Here, PLOD1 is linked to polycystic ovary syndrome.