Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment

Jim Parker, Claire O’Brien, Jason Hawrelak and Felice L. Gersh
Additional contact information
Jim Parker: School of Medicine, University of Wollongong, Wollongong 2500, Australia
Claire O’Brien: Faculty of Science and Technology, University of Canberra, Bruce 2617, Australia
Jason Hawrelak: College of Health and Medicine, University of Tasmania, Hobart 7005, Australia
Felice L. Gersh: College of Medicine, University of Arizona, Tucson, AZ 85004, USA

IJERPH, 2022, vol. 19, issue 3, 1-25

Abstract: Polycystic ovary syndrome (PCOS) is increasingly recognized as a complex metabolic disorder that manifests in genetically susceptible women following a range of negative exposures to nutritional and environmental factors related to contemporary lifestyle. The hypothesis that PCOS phenotypes are derived from a mismatch between ancient genetic survival mechanisms and modern lifestyle practices is supported by a diversity of research findings. The proposed evolutionary model of the pathogenesis of PCOS incorporates evidence related to evolutionary theory, genetic studies, in utero developmental epigenetic programming, transgenerational inheritance, metabolic features including insulin resistance, obesity and the apparent paradox of lean phenotypes, reproductive effects and subfertility, the impact of the microbiome and dysbiosis, endocrine-disrupting chemical exposure, and the influence of lifestyle factors such as poor-quality diet and physical inactivity. Based on these premises, the diverse lines of research are synthesized into a composite evolutionary model of the pathogenesis of PCOS. It is hoped that this model will assist clinicians and patients to understand the importance of lifestyle interventions in the prevention and management of PCOS and provide a conceptual framework for future research. It is appreciated that this theory represents a synthesis of the current evidence and that it is expected to evolve and change over time.

Keywords: polycystic ovary syndrome; evolution; insulin resistance; infertility; toxins; endocrine-disrupting chemicals; environment; lifestyle; diet (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/3/1336/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/3/1336/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:3:p:1336-:d:733387

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().