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Polycystic Ovary Syndrome - What Causes PCOS

According to research, polycystic ovary syndrome (PCOS) contributes to about 40% of all female infertility cases globally, and every woman needs to learn what causes PCOS. In this article, we look at PCOS's potential causes and symptoms, as well as address how to treat PCOS and more.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is a hormonal disorder where the female body produces excessive androgen hormones. PCOS causes swollen ovaries covered with fluid-filled sacs or cysts. 



Moreover, the hormonal imbalance interferes with the functioning of the ovaries, causing irregular or missed ovulation. As a result, you may experience delayed or absent menstruation, making it difficult to get pregnant.

What Are the Symptoms of PCOS?

There are various symptoms of PCOS, which may vary from one woman to another. The most common PCOS symptoms include:

• Infrequent, light, or missed menstrual periods
  
• Excess hair growth on the face and body (hirsutism)
  
• Thick or dark skin patches below the breasts, behind the neck, and under the armpits
  
• Abdominal area weight gain
  
• Saggy skin in armpits or neck
  
• Thinning hair or baldness
  
• Enlarged ovaries with several cysts
  
• Infertility
  
• Oily skin or acne

What Causes PCOS? 

The exact cause of PCOS is not yet known. However, studies suggest that the disorder could arise from the ovaries, the hormone-producing glands, or the brain's function regulating hormone levels. Let's look at some of the potential PCOS causes in detail:

Level of Androgen

Research shows uncontrolled and excessive androgen hormone production inhibits follicle development, causing irregular or no ovulation. Besides, the imbalance leads to swollen ovaries with several cysts. As a result, you may experience missed or irregular periods and struggle to conceive.

Insulin Resistance

Insulin resistance occurs when your body cells become insensitive to the insulin hormone. As a result, your blood sugar levels could rise, and you may have a higher risk of type 2 diabetes and higher levels of insulin. 

Studies suggest insulin resistance is associated with increased androgen hormone secretion, increasing your risk of developing PCOS. 

Hormone Imbalance

Some studies point out a correlation between PCOS and hormonal imbalance. Many women with PCOS reportedly have various hormone fluctuations, such as:

• Reduced sex hormone-binding globulin (SHBG), which regulates the action of testosterone
  
• Excessive testosterone or male hormone secretion which causes excessive facial and body hair growth
  
• High levels of prolactin: prolactin is a hormone that stimulates milk production during pregnancy
  
• Increased luteinizing hormone (LH) levels: LH prompts ovulation
  

Genetic Mutations/Changes in the Womb

PCOS is a complex hormonal problem that results from several factors, including genetic changes. Any changes in the womb or genetic mutations impacting the ovaries relate to PCOS in one way or the other. 

A recent study reported several aromatase gene mutations contribute to the onset of PCOS. According to the findings, the mutations caused increased blood androgen levels and ovary dysfunction, increasing the risk of PCOS.

Family History of PCOS 

Family history and genetics significantly influence PCOS development. A survey revealed that first-degree female relatives of women with PCOS had higher chances of getting affected than those whose families had no PCOS history. Therefore, PCOS is hereditary; if your mother or sister has it, you will likely develop it too. 

Lifestyle Factors 

Some lifestyle factors can increase your risk of having PCOS or aggravate the severity of the disease or its symptoms. For instance, being overweight can increase your risk of hormonal imbalances and insulin resistance. Also, poor diet, stress, and an inactive lifestyle can contribute to the advancement of PCOS.

Treat PCOS 

There are various PCOS treatment options. Your physician will recommend a personalised treatment based on your health status, severity of symptoms, and fertility preference. If you do not wish to have a baby, your options may include:

• Physical activity and diet adjustment: adopting a healthy diet and regular physical exercise can help you lose excessive weight and improve insulin sensitivity, reducing the severity of your symptoms.
  
• Oral contraceptives to help regulate your menstrual cycles and reduce androgen hormone levels and acne
  
• Diabetes medication to improve insulin sensitivity, minimise androgen levels, and curtail excessive hair growth.
  
  

If you plan to get pregnant, your doctor may recommend the following treatment options:

• Medication to stimulate ovulation: the physician may prescribe ovulation-stimulating drugs to help restore regular ovulation and improve your chances of getting pregnant.
  
• Physical activity and diet adjustment: adopting a healthy diet and regular physical exercise can help you lose excessive weight and improve insulin sensitivity, reducing the severity of your symptoms. Also, this can help regularise your ovulation.
  
• Assisted reproductive technology (ART) treatment: your doctor may recommend ART treatment, such as IVF with egg donation, to help you get pregnant if the above options aren't helpful.

Conclusion

If untreated, PCOS can cause discomfort, anxiety, and long-term health problems such as ovarian cancer, diabetes, hypertension, and infertility. Studies are still ongoing to establish what causes PCOS. Presently, some researchers have pointed out several factors aiding the emergence and advancement of the condition. They include lifestyle, hormonal, environmental, and genetic factors.

If you experience any symptoms or suspect having PCOS, consult your fertility doctor. After an evaluation, they can develop a suitable treatment to help improve your quality of life. Besides, your physician can help regularise your ovulation and increase your chances of becoming a parent.

References

• Pasquali, R., Stener‐Victorin, E., Yildiz, B. O., Duleba, A. J., Hoeger, K., Mason, H., & Legro, R. S. (2011). PCOS Forum: research in polycystic ovary syndrome today and tomorrow. Clinical endocrinology, 74(4), 424-433. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2265.2010.03956.x

• Balen, A. (2004). The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best practice & research clinical obstetrics & gynaecology, 18(5), 685-706. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S152169340400094X

• Franks, S., & Berga, S. L. (2012). Does PCOS have developmental origins?. Fertility and sterility, 97(1), 2-6. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2265.2010.03956.x

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