Why Do Polycystic Ovaries (PCOS) Occur? Causes & Symptoms

Polycystic Ovary Syndrome (PCOS) is the most common hormonal condition affecting women of reproductive age. Statistics indicate that nearly 1 in 5 women in India lives with this condition.

Despite its prevalence, PCOS is complex. It is not simply a problem with the ovaries; it is a metabolic and hormonal imbalance that affects your entire body. Whether you are experiencing unexplained weight gain, acne, or irregular cycles, understanding why PCOS occurs is the first step toward managing it.

This guide breaks down the biological reasons for polycystic ovaries, the specific hormonal triggers, and the symptoms to look out for. Knowledge is your most powerful tool in bringing your body back into balance.

What Exactly Is PCOS?

The term Polycystic Ovary Syndrome is slightly misleading. In this condition, the ovaries do not actually have cysts (liquid-filled sacs) in the traditional sense.

Instead, the ovaries are enlarged and contain many tiny, immature egg follicles. In a healthy cycle, one follicle grows and releases an egg (ovulation). In PCOS, the hormonal signals are disrupted, so the follicles never mature enough to release an egg. Instead, they accumulate in the ovaries.

Why PCOS Occurs: The 4 Biological Causes of PCOS

While the exact origin of PCOS involves a complex interplay of factors, medical science identifies four primary mechanisms that drive the condition.

1. Insulin Resistance

This is the leading driver, affecting up to 70% of women with PCOS.

Insulin is the hormone produced by the pancreas to help your body use sugar from food for energy. When you have insulin resistance, your cells do not respond properly to insulin. As a result, your blood sugar levels rise, and your body produces more insulin to compensate.

Excess insulin triggers the ovaries to produce more androgen (male hormones). This specific PCOS hormonal imbalance can prevent ovulation.

2. Androgen Excess

All women produce small amounts of androgens (like testosterone). In PCOS, the ovaries produce abnormally high levels of these hormones. This excess androgen interferes with the brain's signals that trigger ovulation and causes physical symptoms like acne and facial hair.

3. Low-Grade Inflammation

Women with PCOS often have chronic, low-level inflammation. Research shows that this inflammation stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems over time.

4. Genetics (Heredity)

There is a strong genetic component to polycystic ovary syndrome causes. If your mother or sister has PCOS, your likelihood of developing it increases significantly, suggesting that certain gene mutations related to hormone production are passed down through families.

What Are the Common Symptoms of PCOS?

Symptoms of PCOS appear differently in every woman. Some may experience severe physical changes, while others might only notice menstrual irregularities.

Menstrual Irregularities

The most common sign is an irregular menstrual cycle.

• Oligomenorrhea: Infrequent periods (fewer than 9 per year).

• Amenorrhea: Absence of menstruation for three or more months.

• Heavy Bleeding: Because the uterine lining builds up for longer periods without shedding, the flow can be heavier than normal.

Physical Symptoms (Hyperandrogenism)

High levels of male hormones result in visible physical changes:

• Hirsutism: Excess hair growth on the face, chin, or body.

• Acne: Persistent acne, specifically along the jawline and chin.

• Male-pattern baldness: Thinning hair on the scalp.

Bilateral Polycystic Ovaries Symptoms

You may encounter the term "bilateral" in your diagnosis. This simply confirms that both ovaries are affected.

• The Ultrasound: An ultrasound typically reveals enlarged ovaries containing multiple small follicles (often described as a "string of pearls").

• Note: It is possible to have the physical symptoms of PCOS without having the "cystic" ovaries visible on an ultrasound, and vice versa.

If you notice anything that’s not “usual” in your body, firstly, don’t stress out because everything has a treatment if attended at the right time. Consult a gynaecologist, discuss your concerns, and get yourself checked because seeking expert assistance is never a bad idea.

Conclusion

Knowing the reasons why polycystic ovaries occur helps you to take control of your health. Since insulin resistance and inflammation play such major roles, lifestyle adjustments, such as a balanced diet and regular exercise, are often the first line of treatment.

Though a lifelong condition, PCOS is highly manageable. By addressing the root hormonal imbalances, you can regulate your cycle and reduce symptoms effectively.

Unsure if your symptoms are PCOS? Click here to consult a Pinky Promise expert for a proper diagnosis and personalised care plan.

Frequently Asked Questions (FAQs)

Q: Can you have PCOS without cysts?

Yes. The diagnosis of PCOS requires meeting two out of three criteria: irregular periods, high androgen levels, or polycystic ovaries on an ultrasound. You can be diagnosed with the syndrome based on your hormones and periods, even if your ovaries look normal.

Q: Does PCOS cause weight gain?

Yes, weight gain is a common symptom due to insulin resistance. The body struggles to convert sugar into energy effectively, leading to fat storage, particularly around the abdomen.

Q: Is PCOS hereditary?

Evidence suggests a strong genetic link. You are more likely to develop reasons for polycystic ovaries if immediate female relatives (mother, sister, or aunt) also have the condition.

Q: Can I get pregnant with PCOS?

Yes. While the reason why PCOS occurs involves a lack of regular ovulation, many women with PCOS conceive naturally. Others may require fertility treatments or lifestyle changes to restore ovulation and achieve pregnancy.