- Part 1 - Pre-menarche monitoring ("holding pattern"):
Inclusion Criteria:
- Age 8-14.5 years old
- Healthy weight, defined as having a body weight >85% of expected (EBW) and a body mass index (BMI) <99th percentile
- Some breast development
- Pre-menarche
Exclusion Criteria:
- Taking or planning to take medications that affect reproductive hormones in the next 2 to 3 years (e.g. birth control pills, biotin supplements).
- Planning to move more than 60 miles from the CRU within the next 2 to 3 years
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- First-degree relative with polycystic ovarian syndrome, premature ovarian insufficiency, hypogonadotropic hypogonadism, or other pubertal development disorder
- Excessive exercise (defined as running >20 miles per week or its equivalent)
- Pregnancy
Part 2 - Post-menarche cycle tracking:
Inclusion Criteria:
- Age at menarche 10-14.5 years old
- Healthy weight, defined as having a body weight >85% of expected (EBW) and a body mass index (BMI) <99th percentile
- Approximately < 6 months post-menarchal (will typically have completed 4 or fewer menstrual cycles)
- Biochemical criteria: normal thyroid hormone, prolactin, and testosterone levels
Exclusion Criteria:
- Taking or planning to take medications that affect reproductive hormones in the next 2 to 3 years (e.g. birth control pills, biotin supplements).
- Planning to move more than 60 miles from the CRU within the next 2 to 3 years
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- First-degree relative with polycystic ovarian syndrome, premature ovarian insufficiency, hypogonadotropic hypogonadism, or other pubertal development disorder
- Excessive exercise (defined as running >20 miles per week or its equivalent)
- Anemia (defined as hemoglobin <12.0 g/dl)
--Participants with hemoglobin between 11.5 g/dl and 12.0 g/dl may still participate by providing dried blood spots, or no more than 18 ml of blood during any given interval.
Part 3 - Intensive monitoring of ovarian follicle growth
Inclusion Criteria:
- Age at menarche 10-14.5 years old
- Healthy weight, defined as having a body weight >85% of expected (EBW) and a body mass index (BMI) <99th percentile
- Within 1 year of menarche
- Biochemical criteria: normal thyroid hormone, prolactin, and testosterone levels
Exclusion Criteria:
- Taking or planning to take medications that affect reproductive hormones in the next 1-2 years (e.g. birth control pills, biotin supplements).
- Planning to move more than 60 miles from the CRU within the next year
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- First-degree relative with polycystic ovarian syndrome, premature ovarian insufficiency, hypogonadotropic hypogonadism, or other pubertal development disorder
- Excessive exercise (defined as running >20 miles per week or its equivalent)
- Anemia (defined as hemoglobin <12.0 g/dl)
--Participants with hemoglobin between 11.5 g/dl and 12.0 g/dl may still participate by providing dried blood spots, or no more than 18 ml of blood during any given interval.
Part 4 - Late Post-menarche cycle tracking:
Inclusion Criteria:
- Age 11-17.5 years old
- Approximately 2-5 years post-menarchal
- Biochemical criteria: normal thyroid hormone and prolactin
Exclusion Criteria:
- Taking or planning to take medications that affect reproductive hormones in the next 2 to 3 years (e.g. birth control pills, biotin supplements).
- Planning to move more than 60 miles from the CRU within the next 6 months
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- Anemia (defined as hemoglobin <12.0 g/dl)
--Participants with hemoglobin between 11.5 g/dl and 12.0 g/dl may still participate by providing dried blood spots, or no more than 18 ml of blood during any given interval.
Adolescent girls, at-risk daughters, or sisters of women with PCOS
The girls with mothers or sisters with PCOS group will complete the Screening Visit and Parts 1-3. The same inclusion and exclusion criteria apply for Parts 1, 2, and 3 as stated above except that these individuals must have a first-degree relative with PCOS and they can have high androgen levels, excess body hair, and severe acne at screening.
Women with known PCOS (activities for 8 weeks only)
Inclusion Criteria:
- Age >=18-34 years old
- PCOS diagnosis
- at least 3-years post-menarchal with irregular menstrual cycles
- Biochemical (blood) or clinical signs of high androgen levels
Exclusion Criteria:
- Cannot be taking any medications that affect reproductive or metabolic hormones (e.g. birth control pill, biotin supplements, spironolactone, metformin).
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- Pregnancy
Healthy control women (Activities x 2 menstrual cycles)
Inclusion Criteria:
- Age >=18-34 years old
- at least 3-years post-menarchal with regular menstrual cycles every 21-35 days
Exclusion Criteria:
- Cannot be taking any medications that affect reproductive or metabolic hormones (e.g. birth control pill, biotin supplements, spironolactone, metformin).
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- PCOS diagnosis or first-degree relative with disorder
- Pregnancy
Mothers of pediatric participants (Activities for 8 weeks / 2 menstrual cycles)
Inclusion Criteria:
- Age >=18-65 years old
- Biological mother of A Girl's First Period participant
Exclusion Criteria:
- Chronic medical condition, including but not limited to diabetes mellitus, congenital adrenal hyperplasia, cystic fibrosis, sickle cell disease, inflammatory bowel disease, juvenile rheumatoid arthritis, and lupus.
- Pregnancy