What Causes PCOS? The Role of Epigenetics
PCOS and Epigenetics: It Didn’t Start With You
If you have PCOS, you might have wondered why. Was it something you did? Something your mom did? Something you could have prevented? The answer is no. PCOS is deeply rooted in genetics and epigenetics, and the factors that contribute to it may have been set in motion long before you were even born.
The Role of Epigenetics in PCOS
Epigenetics is the study of how genes can be turned on or off by environmental factors without changing the actual DNA sequence. It explains why identical twins with the same genetic code can have different health outcomes. When it comes to PCOS, epigenetics plays a key role in shaping how our bodies respond to hormones, metabolism, and reproductive function.
One of the biggest epigenetic influences in PCOS is exposure to high androgens (male hormones) during fetal development. This can change how genes involved in hormone production and metabolism function, setting the stage for insulin resistance, irregular cycles, and other hallmarks of PCOS later in life.
Androgen Exposure in the Womb
One of the most well-researched pathways in PCOS is the impact of excess androgens during fetal development. When a female baby is exposed to high androgen levels in the womb, it can influence a her developing ovaries and brain, leading to long-term changes in how the body regulates hormones. This exposure can affect genes like P450c17, which controls enzymes that plays a key role in producing androgens. If these enzymes are overactive, the body makes more androgens than it should, contributing to many of the symptoms seen in PCOS.
But here’s the important part—this androgen exposure is not always coming from your mother. It could have been set in motion generations ago.
PCOS Can Be Passed Down for At Least Three Generations
Epigenetic changes are not just limited to a single generation. One study showed they can be passed down for at least three generations, meaning that what happened to your great-great-grandmother (or beyond) could still be affecting you today. If she experienced high androgen exposure due to stress, poor nutrition, or environmental toxins, those changes could have been inherited by the women in your family, increasing the likelihood of PCOS in later generations.
This is why PCOS often runs in families, but it may show up differently from person to person. Some women with PCOS struggle more with insulin resistance and weight gain, while others experience irregular cycles, fertility challenges, or skin issues. The way your body expresses these inherited traits depends on both your genetics and the environment you have been exposed to throughout your life.
Pregnancy, Diet, and Lifestyle Can Also Influence PCOS Risk
While PCOS is largely genetic and epigenetic, environmental factors—especially those during pregnancy—can increase the likelihood of developing it. A mother’s diet, stress levels, and insulin levels during pregnancy all play a role in shaping how her baby’s genes are expressed.
For example, high insulin levels during pregnancy can increase androgen production, which may then affect the baby’s hormonal development. This is one reason why maternal insulin resistance is linked to a higher risk of PCOS in female offspring. While no one chooses to develop insulin resistance, understanding its impact during pregnancy can help future generations lower their risk.
You Did Not Cause Your PCOS
Understanding the role of epigenetics in PCOS is important because it removes the blame. You did not cause your PCOS. Your mother did not cause your PCOS. Even if she also has it, she did not pass it down to you through diet or lifestyle choices alone. The foundation of PCOS was likely laid generations ago, and while we cannot change the past, we can absolutely change how we manage it.
Research shows that targeting insulin resistance can help address the root causes of PCOS. This is why A Low Insulin Lifestyle can be so effective. By managing insulin levels, you can help regulate androgen production, improve ovulation, and reduce many of the symptoms associated with PCOS.
The Takeaway
PCOS is not something you caused. It is not your fault. The roots of this condition run deep, spanning multiple generations. But the good news is that understanding the science behind PCOS gives you the power to manage it in a way that supports your body. While we cannot change the past, we can take control of our health moving forward.
