PCOS Causes

Research opinion | Causes | Role of excess androgen | PCOS and pregnancy

The exact cause of polycystic ovarian syndrome (PCOS) is still not known for sure. But numerous factors play a role in the manifestation of PCOS. The effect of PCOS on ovaries and their production of estrogens, progesterone and testosterone hormones, and the resulting hormonal imbalance have a huge impact on all our body systems. It is essential that PCOS be treated due to the far-reaching impact on women healthcare issues other than possible infertility.

Research opinion

PCOS affects the reproductive system most, but it is essentially an endocrine-system related disorder. Researchers are of the opinion that there is a link between insulin level and PCOS occurrence as women with PCOS are known to have insulin resistance. It is claimed that high androgen (testosterone) and luteinizing hormone levels cause PCOS. Research is on to probe the role of genetics and gene mutation in PCOS.

Causes

The three most important factors that precipitate PCOS are

• Genetics: A woman with a mother or sister with PCOS has a higher chance of getting PCOS.  You can inherit PCOS from either your paternal or maternal family.
• Insulin resistance: Women with PCOS are not able to use up the insulin and excess insulin triggers excess androgen release.
• Hormonal imbalance/deficiency:chronic anovulation because of continuous high estrogen levels>results in elevation of LH (leutinising hormone)and suppression of FSH(follicle stimulating hormone) leading to the characteristic LH/FSH ratio of 2 or more >this altered ratio prevents follicle development and promotes stromal hyperplasia>ovaries therefore produces excess male hormone(androstenedione)>which results in the signs of hyperandrogenism.

Role of excess androgen

One of the main causes for PCOS is the hormonal imbalance.  The ovaries make a nominal amount of androgen generally. But with PCOS, a higher amount of androgen is produced. Because of the insulin resistance in PCOS patients, still more androgen gets released.

Excess androgen causes many of the PCOS symptoms like

• Problems with ovulation.
• Acne.
• Weight gain.
• Hirsutism (excess hair growth – on both body and face).
• Male pattern baldness.
• Dark skin patches.

PCOS and pregnancy

Sometimes women with PCOS get pregnant without awareness of the syndrome or getting treatment for it. There may be complications like

• Miscarriage.
• Gestational diabetes.
• High blood pressure due to pregnancy (preeclampsia).
• Premature delivery.

Outcome

Sometimes there are no outward symptoms except for enlarged ovaries. Infertility, diabetes, lipid abnormalities and endometrial cancer can be long-term healthcare concern if left untreated – even long after menopause.  So it is essential to seek treatment even if you are not keen to become pregnant.

• References

• • Mayo Clinic – PCOS view
  • University of Maryland – Medical Center – Polycystic Ovary Syndrome – Overview view
  • U.S. Dept. of Health – Glossary view
  • NHS UK – PCOS view