Does Spironolactone Normalize Sleep-wake Luteinizing Hormone Pulse Frequency in Pubertal Girls With Hyperandrogenism?

Inclusion Criteria: * Mid- to late pubertal adolescent girls as signified by either (a) post-menarcheal status (Tanner breast stages 2-5) or (b) Tanner breast stage of 4 or 5 (whether pre-menarcheal or post-menarcheal) ages 10-17 years. * Hyperandrogenism, defined as a serum (calculated) free testosterone concentration greater than the Tanner stage-specific reference range and/or clinical hirsutism * General good health (excepting obesity, hyperandrogenism, PCOS, and adequately-treated hypothyroidism) * Willing to strictly avoid pregnancy with use of reliable non-hormonal methods during the study period. Exclusion Criteria: * Inability/incapacity to provide informed consent * Males will be excluded (hyperandrogenism is unique to females) * Age \< 10 or \> 17 years (this study is designed to elucidate mechanisms underlying emerging PCOS in mid- to late pubertal adolescent girls * Post-menarcheal by \> 4 years * Obesity resulting from a well-defined endocrinopathy, or genetic syndrome * To ensure that blood withdrawal is within safe limits, weight \< 21.5 kg is an exclusion criterion. * Since underweight can alter pulsatile LH secretion, BMI-for-age percentile \< 5 is an exclusion criterion. * Positive pregnancy test or current lactation. Subjects with a positive pregnancy test will be informed of the result by the screening physician. Under Virginia law, parental notification is not required for minors. However, the screening physician will encourage the subject to tell her…