Is PCOS a genetic disease, and how can it be managed?

When you’re dealing with irregular cycles, stubborn weight gain, or skin flare-ups well past your twenties, it’s natural to wonder if it’s more than just “hormones acting up.” For many of us, these symptoms don’t appear in isolation—they come with a family history. Polycystic Ovary Syndrome (PCOS) affects up to 1 in 10 women, and genetics may play a much bigger role than we once realised.

The science now shows that PCOS tends to run in families, with researchers identifying specific genes that influence how our bodies regulate hormones like insulin and androgens. In this article, we’ll explore what the research says about the genetic side of PCOS—and how you can still take control of your health, no matter what your family tree looks like.

The Genetics Behind PCOS: What the Research Really Shows

Polycystic Ovary Syndrome is not a random occurrence. It’s a condition rooted in complex disruptions in how our cells manage hormone production—specifically androgens and insulin. And while it’s long been debated, PCOS is now recognised as a familial condition, meaning it does run in families. Studies (4) show a strong genetic component, but the exact genes involved—and how they interact with environmental factors—are still being investigated.

What we do know is that PCOS is incredibly heterogeneous. That means it doesn’t look the same in every woman, and the genes involved can influence many different pathways—like steroid hormone production, insulin function, inflammation, and even how our cells use energy. For instance, the CYP11A gene, involved in the first step of steroidogenesis, has been associated with higher testosterone levels in some studies, though findings have been inconsistent (1). 

Adding to the complexity, research has also highlighted the role of the androgen receptor (AR) gene in PCOS. A 2007 study found that variations in this gene—specifically, the length of CAG repeats within the AR gene—can influence how the body responds to androgens. Women with fewer CAG repeats tend to have heightened androgen sensitivity, which may exacerbate PCOS symptoms like acne, hirsutism, and irregular cycles. This functional genetic variation doesn’t just affect hormone levels—it changes how your body reacts to them, providing another piece of the genetic puzzle (2). 

In essence, if your mother or sister has PCOS, there’s a strong chance those same genetic patterns could influence your health too. But genetics isn’t destiny. The fact that these gene pathways are still being mapped out means there's still room for action—especially when we focus on modifiable factors like diet, exercise, and stress.

How to Manage PCOS if It’s in Your Genes

So, what do you do when PCOS runs in the family? Knowing your genetic predisposition can feel daunting, but it’s also empowering. Why? Because while you can't change your DNA, you can absolutely influence how those genes are expressed. Through targeted lifestyle shifts and carefully chosen nutrients, you can rebalance your hormones, reduce symptoms, and protect your long-term health—naturally.

1. Balance Blood Sugar to Calm Hormones

Insulin resistance is a central feature of many PCOS cases—particularly those with a genetic origin. Stabilising your blood sugar through nutrition is foundational. Focus on slow-digesting carbs like oats, legumes, and root vegetables, and pair them with protein and healthy fats to reduce glucose spikes. Cinnamon, apple cider vinegar, and chromium-rich foods may also support insulin sensitivity. Even small improvements in blood sugar control can ease symptoms like irregular cycles, fatigue, and weight gain.

2. Use Targeted Supplements for Hormonal Support

If you’re managing a genetically-driven hormone imbalance, supplements can help bridge the gap—safely and effectively.

• Magnesium Glycinate: A critical mineral for improving insulin sensitivity, reducing PMS, and calming the nervous system. Our fully reacted formula offers high absorption without digestive discomfort.

• Perimenopause & Menopause Support: With hormone-balancing ingredients like Ashwagandha KSM-66, Peruvian Maca, and natural phytoestrogens, this formulation supports oestrogen modulation, mood, and energy—all crucial for women navigating both PCOS and midlife hormonal shifts.

• Love Thy Gut: Gut health plays a vital role in detoxing excess hormones and supporting immune balance. This prebiotic-rich blend nourishes your microbiome, which in turn regulates inflammation and metabolism—two areas heavily impacted by PCOS.

3. Train Smart: Move with Hormones in Mind

Exercise is one of the most effective ways to improve insulin sensitivity and lower androgens. But not all movement is equal. Focus on strength training 2–3 times per week to increase muscle mass and support metabolic health. Complement this with low-impact cardio like walking, cycling, or swimming, which supports cortisol regulation without spiking stress hormones.

4. Sleep, Stress & Symptom Tracking

Cortisol and androgen levels are closely linked, so managing stress is non-negotiable. Try yoga, breathwork, or journaling to bring down anxiety levels. Track your cycle and symptoms—yes, even if your periods are irregular. This helps you identify patterns, respond early to changes, and monitor how your lifestyle is influencing your hormones over time.

Should You Get Genetically Tested for PCOS?

Given the growing body of research linking specific genes to PCOS, it’s natural to wonder whether genetic testing could provide clear answers—especially if the condition runs in your family. However, while science has made impressive strides in identifying genetic variations associated with PCOS, we’re not yet at a point where a single genetic test can confirm the diagnosis or predict the severity of symptoms.

A 2019 study (3)  explored this very issue, evaluating whether polygenic risk scores—essentially a cumulative score of genetic variants—could distinguish women with PCOS from those without it. The results were promising but not definitive. Although women with PCOS did have higher risk scores on average, there was considerable overlap between affected and unaffected individuals, meaning the test lacked the precision required for clinical use. In other words, a high score didn’t guarantee PCOS, and a low score didn’t rule it out either. 

At this stage, genetic testing may be more useful for research than for everyday diagnosis or treatment decisions. Instead, your family history, symptom pattern, and hormonal profiles remain the most reliable indicators of PCOS risk. If your mother or sister has been diagnosed—and you’re experiencing signs like irregular periods, persistent acne, or unexplained weight gain—it’s worth speaking to a healthcare provider. 

Conclusion

While PCOS has a clear genetic component, your diagnosis is not your destiny. The science confirms that familial and genetic factors shape your risk, but they don't determine your outcome. With a deeper understanding of your body—and the right lifestyle, nutrition, and supplement support—you can manage symptoms, rebalance your hormones, and protect your long-term health. Genetics may set the stage, but you still get to direct the performance.