What Causes Polycystic Ovary Syndrome (PCOS)?
Jan 08, 2022
Source: Cainiu Health
Dr. Lv Aiming
Introduction
1. Abnormalities in secretion mechanisms—commonly involving epidermal growth factor (EGF), transforming growth factor (TGF), inhibin, and others—which impair dominant follicle development and lead to polycystic ovary syndrome (PCOS);
2. Genetic factors inherited within families, supported by the strong familial clustering observed in PCOS;
3. Chronic psychological stress, medications, and underlying diseases;
4. Obesity and hyperinsulinemia.
Polycystic ovary syndrome (PCOS) has multiple etiologies. It may result from abnormal ovarian hormone secretion—for instance, dysregulation of epidermal growth factor or aberrant follicular development—or from genetic predisposition or chronic psychological stress. Moreover, many women develop PCOS after prolonged use of oral contraceptives or weight-loss medications. Consequently, most patients with PCOS are overweight or obese. Below, we address the question: “What causes PCOS?”
What Causes Polycystic Ovary Syndrome?
1. Abnormal Hormonal Secretion Mechanisms
Genetically driven abnormalities in ovarian hormone secretion—such as dysregulation of epidermal growth factor, transforming growth factor, or inhibin—are common contributors to PCOS. These disturbances impair dominant follicle development and ultimately lead to polycystic ovaries.
2. Familial Genetic Factors
The strong familial clustering observed in PCOS indicates that genetic factors play a primary role in its pathogenesis. Most cases of PCOS are associated with gene mutations, while a minority involve chromosomal abnormalities. As this etiological factor is largely unavoidable, early detection and timely intervention are essential.
3. Chronic Psychological Stress, Medications, and Concomitant Diseases
Psychological stress, certain medications, and underlying medical conditions can disrupt the hypothalamic–pituitary–ovarian (HPO) axis, leading to excessive androgen production by ovarian stromal and theca cells. Hyperandrogenism within the ovary inhibits follicular maturation, resulting in characteristic PCOS manifestations—including amenorrhea, hirsutism, and other related symptoms.
4. Obesity and Hyperinsulinemia
A subset of PCOS patients—particularly those who are obese—exhibit hyperinsulinemia and insulin resistance, suggesting insulin resistance as a key pathogenic mechanism. Insulin resistance may arise from various causes; most commonly, it results from post-receptor defects in intracellular insulin signaling pathways, though insulin receptor deficiencies may also contribute.
5. Adrenal Dysfunction
Approximately 50% of PCOS patients demonstrate adrenal cortical dysfunction, often due to adrenal cortical hyperactivity leading to excessive androgen secretion and anovulation. Underlying causes of adrenal dysfunction include adrenal tumors and adrenal cortical hyperplasia.
The above outlines the major etiologies of polycystic ovary syndrome. We hope this information is helpful to you.
