The evolutionary advantage of PCOS: Why our condition was once a superpower #110

Could having PCOS be an advantage?

Happy Holidays! I have decided to dedicate these days between Christmas and New Year to explore where PCOS comes from.

PCOS is classified as a disease; how can it be advantageous? I promise I have not had too much mulled wine, but there is a positive perspective on having PCOS: an evolutionary one.

I thoroughly enjoyed writing this article, and I believe it will be extremely interesting for all of you. So, get a cuppa, find a cosy place, and read or watch it.

In this article:

1. Why do we evolve?

2. Insulin resistance - why has it helped us

3. Increased fat storage - how was it an advantage

4. High testosterone - has it made us survive?

5. How PCOS looked thousands of years ago

6. Could PCOS be an advantage nowadays?

Our bodies have evolved according to our environments. As we speak, our bodies are still changing. Some things might be visible from generation to generation, while others will take millions of years. These evolutions respond to the environment to increase survival. The easiest way to understand evolution is the COVID-19 strains. Viruses evolve in short periods, which is why new strains of COVID-19 keep emerging. They become stronger each time as a way of surviving.

PCOS is an ancient disorder. We know that because it can be found in every corner of the world with more or less the same prevalence. It is thought to have originated before the migration of humans out of sub-Saharan Africa 300,000-50,000 years ago. Some suggest that Hippocrates (460 BC-377 BC) might refer to women with PCOS in this passage: “But those women whose menstruation is less than three days or is meagre, are robust, with a healthy complexion and a masculine appearance; yet they are not concerned about bearing children nor do they become pregnant.”

Our condition is not new; if evolution had kept it till today, there must have been a reason for it! So, you are telling me that having PCOS might have kept me alive a few thousand years ago? Yes, scientists think so.

Let’s see why and whether we can treat PCOS as an advantage in this modern day.

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Something to bear in mind before we jump into this explanation is that evolution doesn’t prioritise health or longevity but reproduction. The human body will ensure genes are passed down, not that you live healthily in old age. This might sound a bit mean, but it’s important to note that genes are selfish. This concept is explored in depth in The Selfish Gene by Richard Dawkins. Genes are selfish entities who have build survival machines “our bodies” to ensure it survives. Once we reproduce and pass down genes, we might not be as useful for them.

To understand why PCOS might have been an advantage a few thousand years ago and why our evolution kept it, we must look at what drives PCOS: insulin resistance, increased fat storage and high testosterone.