<unk>  is caused by a combination of genetic and environmental factors. Risk factors include obesity, a lack of physical exercise, and a family history of someone with the condition. Transgender men may also experience a higher than expected rate of<unk> . Diagnosis is based on two of the following three findings: anovulation, high androgen levels, and ovarian cysts. Cysts may be detectable by ultrasound. Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and high blood levels of prolactin.<unk>  is a heterogeneous disorder of uncertain cause. There is some evidence that it is a genetic disease. Such evidence includes the familial clustering of cases, greater concordance in monozygotic compared with dizygotic twins and heritability of endocrine and metabolic features of<unk> . There is some evidence that exposure to higher than typical levels of androgens and the anti-Müllerian hormone (AMH) in utero increases the risk of developing<unk>  in later life. Genetics The genetic component appears to be inherited in an autosomal dominant fashion with high genetic penetrance but variable expressivity in females; this means that each child has a 50% chance of inheriting the predisposing genetic variant(s) from a parent, and, if a daughter receives the variant(s), the daughter will have the disease to some extent. The genetic variant(s) can be inherited from either the father or the mother, and can be passed along to both sons (who may be asymptomatic carriers or may have symptoms such as early baldness and/or excessive hair) and daughters, who will show signs of<unk> . The phenotype appears to manifest itself at least partially via heightened androgen levels secreted by ovarian follicle theca cells from women with the allele. The exact gene affected has not yet been identified. In rare instances, single-gene mutations can give rise to the phenotype of the<unk> . Current understanding of the pathogenesis of the<unk>  suggests, however, that it is a complex multigenic disorder. Due to the scarcity of large-scale screening studies, the prevalence of endometrial abnormalities in<unk>  remains unknown, though women with the condition may be at increased risk for endometrial hyperplasia and carcinoma as well as menstrual dysfunction and infertility. The severity of<unk>  symptoms appears to be largely determined by factors such as obesity.<unk>  has some aspects of a metabolic disorder, since its symptoms are partly reversible. Even though considered as a gynecological problem,<unk>  consists of 28 clinical symptoms. Even though the name suggests that the ovaries are central to disease pathology, cysts are a symptom instead of the cause of the disease. Some symptoms of<unk>  will persist even if both ovaries are removed; the disease can appear even if cysts are absent. Since its first description by Stein and Leventhal in 1935, the criteria of diagnosis, symptoms, and causative factors are subject to debate. Gynecologists often see it as a gynecological problem, with the ovaries being the primary organ affected. However, recent insights show a multisystem disorder, with the primary problem lying in hormonal regulation in the hypothalamus, with the involvement of many organs. The term<unk>  is used due to the fact that there is a wide spectrum of symptoms<unk> sible. It is common to have<unk>  ovaries without having<unk> ; approximately 20% of European women have<unk>  ovaries, but most of those women do not have<unk> . Environment<unk>  may be related to or worsened by exposures during the prenatal period, epigenetic factors, environmental impacts (especially industrial endocrine disruptors, such as bisphenol A and certain drugs) and the increasing rates of obesity. Along with<unk>  appearing to be inherited as a complex genetic trait that is characterized by both androgen excess and ovulatory dysfunction. Endocrine disruptors are defined as chemicals that can interfere with the Endocrine system by mimicking hormones such as estrogen; "they are of particular interest to reproductive health, including<unk>  and its related symptoms". However, additional research is needed to assess the role that endocrine disruptors may play in disrupting reproductive health among women and<unk> sibly triggering or exacerbating<unk>  and its related symptoms.
Polycystic ovary syndrome
Hypothyroidism
Gonadotropin-resistant ovary syndrome
Hyperprolactinaemia
Functional hypothalamic amenorrhea
Congenital adrenal hyperplasia
Lactational amenorrhea
Metabolic syndrome