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Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment
Version 1
: Received: 3 December 2021 / Approved: 6 December 2021 / Online: 6 December 2021 (15:34:25 CET)
A peer-reviewed article of this Preprint also exists.
Parker, J.; O'Brien, C.; Hawrelak, J.; Gersh, FL. Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment. Parker, J.; O'Brien, C.; Hawrelak, J.; Gersh, FL. Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment.
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; environment; toxins; endocrine disrupting chemicals; dysbiosis; lifestyle; diet
Subject
Medicine and Pharmacology, Obstetrics and Gynaecology
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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