What is the Main Cause of PCOS?

As the most common endocrine disorder in women globally, it is pretty surprising that there remains a lot of confusion surrounding polycystic ovarian syndrome (PCOS) and its manifestation. The most common question is, “What is the main cause of PCOS?”

Is it eating gluten? Is it weight gain? Is it only a hormonal complication? The list of “what ifs” is long and often confusing. The truth behind PCOS is that there is no “single cause” but a combination of genetic, hormonal, and lifestyle-related factors.

This guide from our experts at Bhardwaj Hospital will walk you through the list of causes, the underlying mechanism and how you can reverse the complication.

What is PCOS?

You won’t necessarily understand the cause and mechanism if you aren’t aware of the disease itself. So, before we jump into exploring the “whys”, let us know the “what” first.

What is PCOS? It is primarily a hormonal and metabolic disorder wherein the ovaries produce higher-than-normal levels of androgens (male hormones). This imbalance, in turn, disrupts ovulation in females, causing irregular menstrual cycles.

One key factor about PCOS is its subjectivity. This means that if 10 women are diagnosed with this disorder, chances are that 10 of them might exhibit different symptoms. Some women have visible signs, while others get diagnosed only during fertility consultations.

Does Genetics Play a Role in PCOS Development?

Yes, 100%. In fact, research has established that genetics is one of the strongest factors linked to PCOS.

This means that women who have a family history of PCOS are more likely to develop the condition themselves. If a mother, sister, or even an aunt has PCOS, the chances increase significantly. But does it automatically mean you’d have it if your mother had it? Well, no.

When you have a genetic predisposition to PCOS, it influences how the body processes insulin and produces hormones. Furthermore, variations in specific genes affect the regulation of androgen and insulin production, making women genetically more susceptible to hormonal imbalances.

Alongside genetics, it is usually the influence of environmental or lifestyle triggers which combine to cause the PCOS symptoms.

Is Insulin Resistant the Key Driving Factor Behind PCOS?

If you have heard of PCOS, or watched videos online, you have likely heard the term “insulin resistance” being linked to it. Studies have confirmed that among all the causes identified, insulin resistance is often considered the most significant contributor to PCOS.

So, what is it?

Insulin resistance, as the term suggests, is a condition in which your body’s cells become “resistant” to the insulin that’s produced by your pancreas. This means that even though your insulin production is optimal, the hormone itself is not being utilised properly by the body, causing the body to “produce more of it.”

How does it impact or cause PCOS then?

Well, when there are high levels of insulin in the blood, it directly stimulates the ovaries to produce more androgens. So, when there are excess androgens, it disrupts ovulation, causing menstrual cycle irregularities and infertility as well. It also causes weight gain, another telltale sign of PCOS.

There is ongoing research that has confirmed that obesity, mainly caused by insulin resistance, creates a vicious cycle for the body, one that’s difficult to break out of. So, if you actively work towards losing weight, it improves insulin sensitivity, helping regulate your PCOS symptoms.

Which Hormones Are Associated with PCOS?

Beyond androgens, there are a series of other hormones in the body, which combine to aggravate the PCOS symptoms.

Some of the key hormones that play a role in PCOS development:-

• Luteinizing Hormone (LH) – Elevated LH levels can trigger the ovaries to produce more testosterone.
• Follicle-Stimulating Hormone (FSH) – Lower-than-normal FSH prevents proper maturation of ovarian follicles, leading to irregular ovulation.
• Progesterone Deficiency – Lack of ovulation reduces progesterone production, which disrupts menstrual cycles.
• Estrogen Dominance – Continuous estrogen stimulation without progesterone balance can lead to irregular bleeding.

This is one of the main reasons why getting a thorough hormone profiling is a necessity to target and personalise PCOS treatment. Our gynaecologists and fertility specialists at Bhardwaj Hospital will guide you through the journey with the necessary insights.

Does Inflammation Worsen PCOS?

Not just hormones, a lot of the recent studies indicate that low-grade chronic inflammation is also responsible for worsening your PCOS.

In fact, inflammatory markers are often elevated in women with this condition. Here’s what happens:-

• Inflammation increases insulin resistance.
• It may also stimulate the ovaries to produce more androgens.
• Over time, chronic inflammation increases the risk of cardiovascular diseases, which are already higher in women with PCOS.

So, if you are obese, have a poor dietary routine, smoke or lead a sedentary lifestyle, now is the time to make significant changes to your lifestyle to manage your PCOS better.

Which Environmental and Lifestyle Factors Cause PCOS?

The interplay between environmental and lifestyle factors also plays a crucial role in PCOS manifestation in women.

Some of these external triggers include:-

• Firstly, your diet. If you are eating a diet that contains refined carbs, processed foods, and sugary drinks, it will worsen your insulin resistance, worsening your PCOS.
• Secondly, your activity levels. How often do you exercise or move? Lack of physical activity reduces insulin sensitivity, causes weight gain and increases inflammation, all of which are common triggers of PCOS.
• Thirdly, stress. Chronic stress and high cortisol levels can wreak havoc on your body. It disrupts the hypothalamic-pituitary-ovarian (HPO) axis, which further worsens your hormonal balance.
• Lastly, sleep disorders. If you aren’t getting good-quality sleep throughout the night, it will affect your insulin metabolism, further making your PCOS symptoms worse.

If you are having a hard time navigating through these challenges, that’s where we recommend you consult our doctors at Bhardwaj Hospital. With professional guidance, you can make healthier choices and improve your symptoms.

How PCOS is Diagnosed?

Now that you have a comprehensive understanding of the common causes of PCOS, how will you get it formally diagnosed?

At Bhardwaj Hospital, Noida, we follow a comprehensive diagnostic approach to understand the underlying causes for each patient:-

• Detailed medical and family history evaluation.
• Blood tests to check hormone levels, insulin, and cholesterol.
• Ultrasound imaging to assess ovarian appearance.
• Screening for associated conditions like thyroid disorders or diabetes.

Since PCOS varies widely in symptoms and severity, a customised diagnostic plan ensures that no contributing factor is overlooked.

Depending on the severity, our doctors will then recommend making lifestyle modifications, prescribe medications or suggest fertility treatments. The approach depends on the outcome that the patient is looking for after their diagnosis.

PCOS is Complex, But Manageable

The search for the single “main cause” of PCOS ultimately leads to a convergence of factors: a genetic script that dictates vulnerability, and a metabolic environment, dominated by insulin resistance, that turns that vulnerability into a manifest syndrome.

Do not allow the complexity of PCOS to leave you feeling overwhelmed or resigned to your symptoms.

If you suspect you have PCOS, or if you have been diagnosed but feel your current management plan is falling short, avail the best PCOS treatment in Noida. Schedule your consultation at Bhardwaj Hospital today!