Understanding the inheritability of PCOS

Polycystic ovary syndrome, or PCOS. doesn’t follow a simple “one gene = one condition” rule. Rather, it’s polygenic and multifactorial, meaning you likely inherit a susceptibility, not a guarantee. 

Studies show that about 40% of women with PCOS have a first‑degree relative (mother or sister) who also has PCOS or an androgen excess disorder.

Consider this particularly striking figure: If your sister has PCOS, your risk is around 40%, but if your mother has PCOS, the rate among daughters is often a bit lower, perhaps because mothers may have undiagnosed or milder forms, or because the condition’s expression changes with age.

That inherited predisposition might revolve around how your body handles insulin, hormone receptors, or inflammation responses. Add environment (diet, stress, sedentary habits) and triggers (e.g. weight gain, puberty changes) and the equation tips toward PCOS expression.

You don’t “catch” PCOS like a cold, you may carry the risk, and when your internal and external environments line up the wrong way, PCOS symptoms emerge.

READ MORE | Insulin resistance could be affecting your fertility

Family histories

 It’s not always obvious from family history who has or had PCOS, because the phenotype (how PCOS shows up) can vary widely.

Some women have mostly metabolic symptoms (insulin resistance, weight gain), others more skin or hair or menstrual irregularities.

A woman might carry PCOS predisposition but never have been diagnosed because she had mild symptoms or found ways to compensate.

Older female relatives may have gone through menopausal or post‐childbearing years without evaluation. They might have had irregular cycles or acne years ago, but diagnosis criteria were different, or medical access was limited.

In some studies, a mother might not report PCOS even though the daughter has it, this might reflect under‑diagnosis, or varying awareness. 

Blame it on sugar

 While genetics lay the groundwork for PCOS, non-genetic (environmental and lifestyle) factors often pull the trigger and sometimes pour fuel on the hormonal fire.

For instance, over 50–70% of women with PCOS have insulin resistance, but that number climbs even higher in women who are sedentary, eat high-glycaemic diets, or experience chronic stress.

A 2020 study found that women with PCOS who had a poor diet (high in refined carbs and trans fats) had three times greater symptom severity than those following a balanced, fibre-rich, anti-inflammatory diet.

Stress is another stealthy culprit: chronic cortisol spikes can worsen androgen production and disrupt ovulation. Even sleep plays a role, women with PCOS and poor sleep habits are more likely to experience worsening metabolic symptoms and higher levels of inflammation.

Add in endocrine disruptors (like BPA in plastics or certain cosmetics), and your hormones may be working overtime just to stay semi-balanced. The bottom line is, your genes may load the gun, but lifestyle often pulls the trigger which means there’s a lot you can do to take control.

Supplements that support hormones

 Supplements containing myo-inositol have become a secret weapon in the PCOS toolkit and not just because they’re trendy.

Myo-inositol is a naturally occurring compound that helps your body respond better to insulin, and that’s a big deal since up to 70% of women with PCOS have insulin resistance lurking in the background.

Think of it like a hormone traffic controller, when it’s doing its job, your insulin and blood sugar flow smoothly. When not cued the chaos to irregular cycles, acne, hair growth in weird places, and stubborn weight gain.

Studies have shown that taking 4,000 mg of myo-inositol daily (like what’s in Lamelle Pharmaceuticals, Ovaria) can help restore ovulation, regulate periods, and even improve egg quality, often within 3 months.

On the flip side, skipping support like this can let insulin resistance quietly worsen, which may push you further down the metabolic rabbit hole (hello, prediabetes, fatigue, and even infertility).

Smooth operator

 If you’re over the “gulp and grimace” routine, why not turn your daily dose into something a little more delicious like a smoothie?

Myo-inositol powders like Ovaria (which come in yummy peach and orange flavours) blend beautifully into a nutrient-packed shake.

Try this – toss in half a frozen banana, a handful of spinach, half a cup of berries, a tablespoon of chia seeds, a scoop of plain Greek yogurt or your favourite plant-based alternative, and one cup of unsweetened almond milk.

Add your Ovaria sachet (or even half of each flavour for a fruity twist), blend it up, and boom you’ve got a hormone-friendly, blood-sugar-balancing treat that feels more like self-care than a supplement.

PCOS isn’t just about the genes you inherit, it’s a mix of your family story and the lifestyle choices you make every day. Think of it as a recipe, your DNA hands you the ingredients, but how you cook it (diet, sleep, stress, movement) determines the final dish.

The good news? Unlike those family genes, your lifestyle is totally in your control. Adding smart supplements with the optimum daily dose of myo-inositol, can be the game-changer your hormones have been waiting for.

As Dr. Bradley Wagemaker puts it; “Understanding your risk empowers you to take charge, PCOS doesn’t have to write your story.” Here’s to mixing science, self-care, and a little sweetness for a healthier, happier you!

Author: Pedro van Gaalen

When he’s not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He’s worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.