Stressors can activate three different cascades: the HPA axis, the SAS and the HPG axis. Stress can also increase levels of GnIH, which has an inhibitory effect on the HPG axis.

It requires an intact hypothalamic–pituitary–gonadal (HPG) axis and is heralded by the reemergence of gonadotropin-releasing hormone (GnRH) secretion from its relative quiescence during childhood.