Polycystic Ovary Syndrome (PCOS), a hormonal condition affecting women of reproductive age, remains one of the most common causes of infertility worldwide. The syndrome is marked by irregular menstrual cycles, elevated androgen levels leading to acne and excess hair growth, and enlarged ovaries containing multiple small cysts. It is often linked to insulin resistance and a range of metabolic complications.
The prevalence of PCOS has risen sharply in recent years, a trend attributed to obesity, sedentary lifestyles, dietary changes, and environmental influences. Greater awareness and improved diagnostic methods have also contributed to the increase in reported cases.
As September marks PCOS Awareness Month, Dr. Ashwin Shetty, Consultant in Obstetrics & Gynaecology at Sir H.N. Reliance Foundation Hospital, addressed a key question: is PCOS primarily a lifestyle disorder, or does genetics play the leading role?
Genes Set the Foundation
“There is strong evidence that PCOS has a genetic basis,” Dr. Shetty explained. “I often see women whose mothers, aunts, or sisters had similar issues—irregular periods, infertility, or diabetes. Certain genetic factors predispose the ovaries to release more androgens, which disrupt ovulation and trigger symptoms such as acne, hirsutism, and ovarian cysts.”
Lifestyle Shapes the Outcome
While genetics create the underlying risk, lifestyle can significantly influence how PCOS manifests. “Insulin resistance, a hallmark of PCOS, is worsened by poor diet, lack of exercise, stress, and weight gain. On the other hand, women with the same genetic risk often show minimal symptoms if they maintain a healthy lifestyle,” Dr. Shetty said.
This interplay explains why PCOS presents so differently even among family members. “Genes may write the prologue, but lifestyle often dictates the story,” he added.
Beyond Genes and Habits
Experts also point to environmental factors, hormonal imbalances, inflammation, and insulin resistance as contributors to PCOS. These complex interactions make the condition highly variable across patients.
Managing PCOS
Although there is no cure, PCOS can be managed effectively through early diagnosis and comprehensive care. “It’s not something caused purely by habits, nor something beyond your control,” Dr. Shetty emphasized. “With regular exercise, balanced nutrition, weight management, and stress reduction, women can restore hormonal balance, regulate cycles, and improve fertility.”
Uncontrolled PCOS raises the risk of type-2 diabetes, cardiovascular disease, sleep apnea, and mood disorders such as anxiety and depression. According to the World Health Organization, it is the leading cause of anovulation-related infertility.
“In essence, genetics lay the groundwork for PCOS, but lifestyle determines how it unfolds. The good news is, women have the power to influence that trajectory,” Dr. Shetty concluded.
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