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424,425,426,427 In addition to NADH produced in the mitochondria by the TCA cycle, cytoplasmic NAD + generation is essential for insulin secretion

So not something within the ovary or a lack of the pituitary to make LH or FSH, but a deficit of the hypothalamus to promote LH and FSH and the downstream hormones, testosterone and estrogen

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In Europe, including France, the Netherlands, and Germany, approximately 50% of women of reproductive age (15-49) take oral contraceptives for birth control purposes, and they are also used as a treatment for acne