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Causes
By Mayo Clinic staffYour normal reproductive cycle is regulated by changing levels of hormones produced by the pituitary gland in your brain and by your ovaries. The pituitary gland produces follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which control the growth and release of eggs (ovulation) in the ovaries. During a monthly cycle, ovulation occurs about two weeks before your period.
Your ovaries secrete the hormones estrogen and progesterone, which prepare the lining of the uterus to receive a fertilized egg. The ovaries also produce some male hormones (androgens), such as testosterone. If pregnancy doesn't occur, estrogen and progesterone secretion decline and the lining of the uterus is shed during menstruation.
In polycystic ovary syndrome, the pituitary gland may secrete high levels of LH and the ovaries may make excess androgens. This disrupts the normal menstrual cycle and may lead to infertility, excess body hair and acne.
Doctors don't know the cause of polycystic ovary syndrome, but these factors likely play a role:
- Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose), your body's primary energy supply. If you have insulin resistance, your ability to use insulin effectively is impaired, and your pancreas has to secrete more insulin to make glucose available to cells. The excess insulin is thought to boost androgen production by your ovaries.
- Heredity. If your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that mutated genes are linked to PCOS.
Researchers continue to explore possible causes of PCOS. Among topics of current research are whether low-grade inflammation and fetal exposure to excessive androgens might trigger the condition.
- Wilson EE. Polycystic ovarian syndrome and hyperandrogenism. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3157034. Accessed June 22, 2009.
- Barbieri RL, et al. Clinical manifestations of polycystic ovary syndrome in adults. http://www.uptodate.com/home/index.html. Accessed June 22, 2009.
- Ehrmann DA. Polycystic ovary syndrome. New England Journal of Medicine. 2005;352:1223.
- Azziz RA, et al. The androgen excess and PCOS society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility. 2009;91:456.
- Polycystic ovary syndrome (PCOS): Frequently asked questions. U.S. Department of Health and Human Services Office on Women's Health. http://www.4woman.gov/faq/pcos.pdf. Accessed June 16, 2009.
- Guzick DS. Polycystic ovary syndrome. Obstetrics & Gynecology. 2004;103:181.
- Radosh L. Drug treatments for polycystic ovary syndrome. American Family Physician. 2009;79:671.
- Barbieri RL, et al. Treatment of polycystic ovary syndrome in adults. http://www.uptodate.com/home/index.html. Accessed June 22, 2009.
- Tapanainen JS, et al. Effective regimens for ovulation induction in polycystic ovary syndrome. In: Dunaif A, et al. Polycystic Ovary Syndrome: Current Controversies, From the Ovary to the Pancreas. Totowa, N.J.: Humana; 2008:307.
- Gonzalez F (expert opinion). Mayo Clinic, Rochester, Minn. July 3, 2009.
