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Polycystic ovary syndrome: an evolutionary adaptation to lifestyle and the environment

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Version 2 2025-04-23, 00:32
Version 1 2023-05-21, 13:46
journal contribution
posted on 2025-04-23, 00:32 authored by J Parker, C O'Brian, Jason HawrelakJason Hawrelak, FL Gersh
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.

History

Publication title

International journal of environmental research and public health

Volume

19

Issue

3

Article number

1336

Number

1336

Pagination

1-25

ISSN

1660-4601

Department/School

Pharmacy

Publisher

MDPI

Publication status

  • Published

Place of publication

Basel

Rights statement

© 2022. The Authors. Licensee MDPI, Basel, Switzerland. This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License, (https://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Socio-economic Objectives

200105 Treatment of human diseases and conditions

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