What Are the Main Causes of PCOS?

Polycystic ovary syndrome, also known as PCOS, affects about one in ten women of childbearing age, as reported by the OASH. This syndrome is complex and not well understood. However, what is known is that PCOS affects many normal body systems and functions. This fact is clear by the wide range of symptoms you may suffer from if you have PCOS. 

A few of the most common polycystic ovary syndrome symptoms include:

  • Irregular periods (including missed or very light periods)
  • Cysts on the ovaries
  • Excessive body hair
  • Body hair in abnormal places for women (like the face or chest)
  • Acne
  • Oily skin
  • Weight gain without other clear causes
  • Hair loss or thinning hair
  • Infertility
  • Darkening or thickening of the skin in certain places 

These symptoms can negatively impact a woman's quality of life and cause significant emotional distress. For example, struggling with fertility when hoping to conceive can cause depression, anxiety, and even feelings of guilt. 

Although you can't cure polycystic ovary syndrome, there are many ways you can manage the symptoms. If you've been diagnosed with PCOS, it's essential to understand what causes polycystic ovary syndrome

You May Be Wondering, What Is PCOS Caused By?

What are the main causes of PCOS? Studies have found genetics, high androgen levels, high insulin levels, and inflammation can all be contributing factors. We discuss each of these PCOS causes more in-depth below. 


PCOS has a strong genetic association, as stated by Endocrine Web. Although how or why genetics work in this condition is still under research. When a disorder is genetic, it means you're more likely to have it if a family member does. For example, if your mother, grandmother, or sister has polycystic ovary syndrome, you're significantly more likely to have it. But, if you don't have any close female relatives with PCOS, you're less likely to have it.

Which Genes Are Responsible?

Scientists aren't positive which genes cause PCOS. However, several genes have been discussed as the potential origin of PCOS. Although more research is needed, a few of the genes currently being discussed in a recent Science Direct study include:

  • CAPN10
  • Cytochrome family p450
  • Insulin gene
  • AR
  • FTO
  • FSHR

If you aren't a scientist or medical professional, you're probably wondering what these genes are or what they mean. However, it's not important to understand what each gene is. Instead, you should understand what identifying a handful of potential genes means. It means conclusive identification of PCOS-causing genes could be on the horizon.

Identifying which gene is responsible for the syndrome means being one step closer to understanding why it's genetic and why it develops in some women but not others. 

Does "Genetic" Mean All Family Members or Only Some?

Not all relatives are created equally when defining how likely you are to have something, like PCOS. When it comes to genetics, your direct relatives are those that matter most. For female conditions, these include:

  • Your mother
  • Your grandmother
  • Your sisters 

Although other female relatives could have an impact on your odds of having a genetic condition, it's much less likely. However, genetics isn't the only cause of PCOS. 

High Levels Of Androgens

Women with polycystic ovary syndrome have higher levels of androgens than those who don't have the condition. Androgens are hormones that occur naturally in all humans but less so in females. Hormonal imbalances and high levels of androgens specifically are some of the leading causes of PCOS. 

What Are Androgens?

An androgen isn't a single hormone. Instead, androgens are a group of hormones that include the male-dominant hormone, testosterone. Besides testosterone, the other androgen hormones are:

  • Androstenediol (also known as A5)
  • Dehydroepiandrosterone (also known as DHEA)
  • Dehydroepiandrosterone sulfate (also known as DHEA-S)
  • Androsterone
  • Androstenedione (also known as A4)
  • Dihydrotestosterone (also known as DHT)

Androgens are precursors to estrogens. This means androgens are required to produce estrogen-type hormones. In women, androgens are created in fat cells, the ovaries, and the adrenal glands. The body then turns androgen into estrogen, which is essential for female reproductive health. Women with PCOS may notice they have lower estrogen levels alongside high levels of androgens.

What Do Androgens Do?

Androgens are traditionally thought of as a male hormone, although they exist in biological males and females. Everyone needs a certain amount of androgens for certain essential body functions. 

A few functions androgens help with include:

  • Reproductive functions (in both males and females)
  • Cognitive functioning
  • Development of lean muscle mass
  • Optimal muscle functioning
  • Bone strength
  • Body hair growth
  • Libido
  • Location of fat cells

What Does Hormonal Imbalance Really Mean?

Everyone, regardless of gender, has hormones. But, biological men have different levels of specific hormones than women do. When hormones are too high or too low for a specific gender, they can disrupt the body's natural processes.

For example, excessive estrogen levels in women can cause weight gain and depression. In women with PCOS, high levels of androgens cause many of the most disruptive symptoms. Elevated androgens can cause excessive body growth and infertility, among others. 

What Hormones Should Women Have?

The primary hormones women should produce are estrogen and progesterone. So if you had a hormone panel done, you'd want to see higher levels of these two hormones over others.

Like androgens, estrogen isn't a single hormone but a group. There are three primary estrogen hormones - estrone, estradiol, and estriol. 

Although the female body requires certain androgens (like testosterone), levels should be significantly lower than the primary hormones above. 

But your body has many other hormones besides those considered "sex hormones." In fact, even insulin is a hormone. Hormones, in the right amounts, are crucial for human health. 

A few additional hormones women's bodies naturally produce include:

  • Cortisol (the "stress hormone")
  • HGH (the "growth hormone")
  • Adrenaline (responsible for the fight or flight response)
  • Thyroid hormones (which helps regulate metabolism)
  • Follicle-stimulating hormone (responsible for egg growth in the ovaries)

High Levels Of Insulin

Women with PCOS often have high levels of insulin. Although this is sometimes confused with diabetes, the two are very different.

If you have PCOS, your blood sugar is often normal. However, a fasting blood test will show you have abnormally high insulin levels. This is called insulin resistance. Since the body resists using insulin, the pancreas has to continue making more. Having too much insulin in the body can directly cause inflammation.

On the other hand, people with diabetes don't produce enough insulin, or their bodies don't utilize insulin effectively. So if a person with diabetes checks their blood sugar (without taking insulin or medication) after eating, their blood glucose level will likely be high.

However, while insulin resistance in PCOS and diabetes are different, they can go hand-in-hand. Insulin resistance can eventually lead to Type 2 diabetes. 

High Insulin Isn't Just a Symptom

One common misconception is that high insulin is simply a symptom of PCOS. However, this isn't entirely correct. High levels of insulin could be directly to blame for the development of the syndrome and some of its most prominent symptoms.

For example, high insulin could cause infertility because it impairs ovulation. High insulin can also cause the ovaries to create excessive amounts of testosterone. As discussed above, testosterone is an androgen, and women with PCOS often have high levels of androgens. As you can see, the different causes of polycystic ovary syndrome are intricately linked. 


You've probably heard the term inflammation before, but do you know what it really means?

Inflammation happens when your body's immune system reacts to a foreign substance. This reaction's goal is to protect your body from perceived threats. Unfortunately, these reactions aren't also appropriate.

In some people, the body's immune system identifies things that occur in the body normally as foreign substances. In people with autoimmune diseases, the immune system attacks the body or even itself. 

This is what happens when you have PCOS. Your immune system gets triggered inappropriately. Instead of fighting off an actual threat, it targets your own cells and tissues. This leads to inflammation throughout the body. 

Some people with PCOS also have high levels of other inflammatory markers. 

These include elevated levels of: 

  • oxidative stress
  • inflammatory cytokines
  • lymphocytes
  • monocytes

Insulin resistance can cause inflammation. Yet again, we can see how the various causes of PCOS are intricately linked.

Find The Right PCOS Support For You

You now know the answer to "what are the main causes of PCOS?" If you believe you have PCOS, talking to your primary care physician is essential. Only a doctor can diagnose your polycystic ovary syndrome so you can begin treating and managing your symptoms.

One of the best ways to manage your PCOS symptoms is through supplementation designed to balance your hormones and optimize reproductive functioning. Learn more about the Knowell PCOS supplement today. 

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