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Although the exact cause of polycystic ovary syndrome (PCOS) is unclear, researchers believe that both genetic factors and insulin resistance play a role in the pathogenesis of PCOS.

Genetic Factors

Some researchers have suggested a genetic link in PCOS since it appears to be more prevalent in some families. Studies indicate that approximately 45% of siblings of women with PCOS have hyperandrogenism and its presence increases the risk for PCOS three-fold. Other studies have found that first- degree relatives of girls with premature pubarche have higher rates of gestational diabetes, abnormal glucose tolerance, and Type II diabetes, all of which are related to PCOS. The possibility arises that there may be a genetic predisposition to PCOS that when combined with unknown other factors cause the development of PCOS in some women.

Insulin Resistance

There is a hypothesis that attributes the cause of PCOS to the body's inability to process insulin since an important factor associated with this syndrome appears to be insulin resistance. Moreover, several symptoms associated with insulin resistance are also associated with PCOS, including hyperandrogenism, obesity, distribution of body fat, acanthosis nigricans, cardiovascular disease, and Type II diabetes). It is thought that for some unknown reasons (possibly due to a genetic defect) the body does not use insulin efficiently. This may cause insulin resistance and hyperinsulinemia which increases androgen production resulting in symptoms of PCOS.