Let’s put that question to you first—what are the effects of PCOS (Polycystic Ovary Syndrome) on your body? What causes it?
While it’s true that PCOS has become more prevalent than it was a decade ago, and of course, factors like poor lifestyle, lack of exercise, and unhealthy eating habits are to be blamed, little did you know that this is an ancient disorder. PCOS isn’t a recently-emerged disease.
According to a study published in the National Library of Medicine, the origin of PCOS is reported to be not just genetic but also associated with other physiologic and metabolic abnormalities such as obesity, type II diabetes, heart disease, and hypercholesterolemia. The references to this syndrome date back to the ancient Egyptian papyri and are mentioned not only in ancient Hebrew & Greek literature but also in the Renaissance & medieval periods. PCOS is believed to predate the emergence of human racial diversity at least 50000 years ago.
Now, coming back to your question—what causes PCOS?
Even after hundreds of years, the underlying reason for PCOS remains a mystery.
The causes of PCOS are still unknown. (Source: NHS)
Of course, genetics is one of the factors, but it isn’t the only factor. Let’s discuss every PCOS-triggering factor in detail and understand how it affects your body.
The basic reason for PCOS, or at least in part, is your ‘genes,’ and they play a crucial role in creating a hormone cascade.
According to this study, 24% of women with PCOS said their mothers had the condition, whereas 32% said one of their sisters suffered one. This means you can easily inherit the risk of PCOS or other metabolic abnormalities if one of your family members (a woman) has it.
However, there isn’t a single PCOS gene that’s behind it. Multiple mechanisms and various genes seem to work, which explains why PCOS has different symptoms, developing at different ages.
Genes affect insulin resistance and hormone levels. Most women with PCOS gain weight, which contributes to insulin resistance. Though obesity aggravates insulin resistance, this doesn’t mean lean women with the syndrome don’t undergo one. Whether obese or lean, women with PCOS will experience insulin resistance. (Source: NLS)
|How genes affect your body and trigger PCOS: According to Science Direct, it isn’t just a single gene but 240+ gene variations that causes PCOS. Polymorphism, or a nucleotide change, causes a defect in the gene’s overall transcriptional activity, which leads to PCOS.
And a defect in a gene perturbs the overall biochemical pathway, leading to dysfunction of the ovary. PCOS progression increases with an increase in insulin and androgen levels. Elevated androgen levels stimulate your VAT (Visceral Adipose Tissues) that generate FFAs (Free Fatty Acids), which contribute to insulin resistance.
2. Insulin resistance
About 70% of women with polycystic ovary syndrome have insulin resistance, meaning their cells cannot utilize insulin properly or how they should. This red sign conveys two things: you might have prediabetes or are at risk for diabetes.
Insulin is a hormone that your pancreas produces. It helps your cells to utilize sugar: your body’s critical energy supply. But when your cells become resistant to insulin, your blood sugar levels rise. Not just that, your body produces more insulin, which increases androgen production and causes complications with ovulation.
Insulin resistance (or impaired insulin sensitivity) is an issue that occurs when your body fails to send adequate glucose to your cells that need fuel to function. And when this happens, your pancreas produces more insulin to help keep the glucose levels balanced.
But that “extra” insulin leads to various adverse effects. It causes obesity, increases the risk of type II diabetes, and much more. (Source: NIH)
|How excess insulin affects your body: Elevated insulin levels affect the way your ovaries function. It triggers them to generate more androgen (or male hormones), suppressing ovulation and contributing to other PCOS symptoms. While not all women with insulin resistance will have increased glucose levels or diabetes, it can cause diabetes.
In addition, insulin resistance may cause skin changes (such as appearance of skin tags or hyperpigmentation) and contributes to stubborn weight gain, making other symptoms of PCOS worse.
3. Higher androgen levels
Androgens are sex hormones that help individuals enter puberty, maturing physically. Androgens not only impact sexual health but also plays a crucial role in insulin sensitivity, metabolism, and overall body composition (total amount of body muscle and fat).
Women with higher androgens levels are more likely to suffer improper ovulation because it alters the levels of gonadotropin-releasing and luteinizing hormones, both of which help initiate the menstrual cycle.
Now, this has a chain reaction. When you don’t ovulate regularly, it causes irregular periods (scientifically known as amenorrhea), infertility, development of ovarian cysts (most but not all women).
|How high androgen levels affect your body: Excess androgen prevents your ovaries from releasing the eggs (or ovulation), causing irregular periods. Irregular ovulation also builds up tiny, fluid-filled sacs in the ovaries. Further, higher androgen levels cause acne and excess hair growth on women’s chest, face, arms, neck, and legs.
Androgens also impact the endometrium’s function (or uterus lining) and play a vital role in helping a woman prepare for a potential pregnancy. Above all, androgens also impact cardiovascular health and bone density.
4. Irregular menstrual cycles
Most women with PCOS have irregular periods that experience either delayed or no period (also known as amenorrhea). The culprit? Hormonal imbalances. And these can cause infertility too.
Speaking of the menstrual cycle, know this. Usually, a follicle matures every month, and the ovaries release it so it can fertilize. But for a woman with PCOS, the follicle doesn’t get released. It stays inside the ovaries, which can only be detected via ultrasound.
The ovulation doesn’t occur, and the uterus fails to receive the necessary stimulation to shed the lining. Due to these, it causes ovulatory infertility.
Your periods might be light because you aren’t ovulating or too heavy because the uterus lining thickens, as the monthly cycle does not happen. Women with PCOS generally have less than 6-8 periods per year (the normal is about 10-17 periods per year). On the other hand, 10-15% of women with PCOS have longer cycles, lasting about 32-36 days.
|How amenorrhea affects your body: Amenorrhea has a few complications. Not having periods can make women go through psychological stress. Since you aren’t ovulating, you don’t have menstrual periods, decreasing the chances of becoming pregnant. It causes infertility and makes it hard for a woman to conceive.
According to this report, infertility affects about 80% of women with PCOS. But here’s some good news for women who want to get pregnant: Lifestyle changes, healthy eating habits, ovulation-inducing medications, and other fertility treatments can help overcome PCOS and increase the chances of conceiving.
5. Low-grade inflammation
Inflammation is a body’s natural response to viruses or injuries. It is a complex process which starts with your immune system. While it’s good and is meant to defend your body to promote healing, chronic inflammation causes multiple issues.
Chronic inflammation occurs when your inflammatory response pursues, although you aren’t injured or sick. Often seen as an autoimmune condition — like rheumatoid arthritis and lupus — where your immune system misunderstands your body’s tissues as a foreign threat.
The process of chronic inflammation is slow and lasts for months or even years. It is often called ‘low-grade inflammation’ because it is less of a tidal wave and more of a steady and slow drip. On the other hand, acute inflammation lasts as long as your body has to heal.
A study report says that chronic, low-grade inflammation is one of the key contributors of PCOS too. Inflammation levels are measured by checking the biomarkers in the bloodstream, even including CRP (C-reactive protein). Typically, women with PCOS have higher CRP levels.
|How low-grade inflammation affects your body: According to healthline, low-grade inflammation that’s linked with PCOS gives rise to different health complications, which include infertility, type II diabetes, and heart diseases.
However, the good thing is that all of these are reversible. A good thumb rule is to eat foods that are fortified with vitamins, minerals, proteins, antioxidants and other nutrients. Include anti-inflammatory foods. Stay away from refined carbohydrates (such as pastries, white bread, cakes, and donuts), beverages, sugary snacks, alcohol, processed meats, cheese, milk, dairy products, and foods with preservatives.
Other risks linked with reproductive cancers: Breast, Endometrial, and Ovarian
As said in pointer #4, irregular menstrual cycles cause the uterus lining (or the endometrium) to develop and thicken continually — instead of — shedding once in 28 days, which is usually the case with regular periods.
Now, this buildup increases the chances of endometrial hyperplasia, a condition where the cells in the endometrial lining group together and start taking some abnormal shapes. Also, it triples the chances of endometrial cancer, especially in women with PCOS. (Source: PubMed)
However, the American Cancer Society also reveals that despite increased chances of endometrial cancer in PCOS patients, you must know that it is a rare cancer form, affecting only 24 in 100000 women annually.
After citing different research papers, it’s evident that PCOS is linked to metabolic syndrome and insulin resistance. While this type of metabolism serves as a benefit during food scarcity because insulin resistance transmits a relative “fuel efficiency.”
During old ages, women with insulin resistance survived because food accessibility was hard, and everyone toiled to create shelter, stay safe, and keep warm. However, modern times call for a sedentary lifestyle with effortless access to food.
We no longer have to go through strenuous physical work, which is great but has some serious consequences like diabetes, obesity, heart diseases, and even a few types of cancer.
Also, back in those days, although women suffered from PCOS, they still conceived successfully because of their metabolic efficiency. They lived healthier and longer. Another significant difference these days is the duration we wait to reach adulthood to begin our families, whereas, in ancient times, adulthood began in the teen years.