Rare and Underappreciated Causes of Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a common cause of infertility in women, often linked to insulin resistance. However, this document highlights several underappreciated causes of PCOS, including autoimmune diseases, insulin receptor mutations, hormonal signaling pathway polymorphisms, endocrine disruptors, and alterations in the gut, oral, or vaginal biome. Parasitic infections, such as neurocysticercosis, can induce PCOS by synthesizing steroid hormones. The document also discusses the role of the gut microbiome in PCOS, with studies showing associations between gut dysbiosis and PCOS. Vitamin D deficiency, found in 67-85% of women with PCOS, may worsen symptoms like insulin resistance, ovulatory and menstrual disturbances, and obesity. Sleep disorders, light and noise pollution, and non-classic adrenal hyperplasia are also associated with PCOS. The document concludes that understanding these diverse causes can lead to improved preventive strategies and individualized treatment.