Role of genetic, environmental, and hormonal factors in the progression of PCOS: A review

Polycystic ovary syndrome (PCOS) can be mainly defined as a gynecological problem accompanied by an endocrine disturbance in females and can be seen mainly during their menstruation age. Worldwide PCOS prevalence ranges between 6% and 10%. Many of the risk factors are responsible for the pathogenesis of PCOS. Environmental factors such as environmental toxins and obesity play a major role in the occurrence of PCOS, followed by the hormonal disturbance in androgen levels, that is, hyperandrogenism, and insulin levels, that is, hyperinsulinemia. The previous studies have suggested that there is a major contribution of genetics in the etiology of PCOS. However, there is no strong evidence about the mode of inheritance of PCOS. It has been seen that there is a strong correlation between environmental, hormonal, and genetic factors which follow a vicious cycle in the development of PCOS that leads to ovarian dysfunction, metabolic syndrome, that is, metabolic abnormalities include insulin resistance, obesity, hypertension, dyslipidemia, and abnormal cholesterol level. The detailed study of PCOS is one of the most central topics in female reproductive endocrinology. On the other hand, the syndrome has been extensively investigated; however, its definition and pathophysiological aspects are still not very clear. The idea behind the current review was to make a non-systematic review of already published literature through PubMed and Google Scholar search. The keywords searched and publications were related to polycystic ovaries, including the incidence, environmental factors, genetics, hormones, as well as their association. The aim of the current review is to update the evidence regarding the pathogenesis of PCOS and emphasizes how genetic, non-genetic, and hormonal factors lead to the progression of PCOS.