Increased levels of sex hormone-binding globulin, which is influenced by fat stored in the hips and thighs, reduce the amount of free testosterone in the body, and this mechanism accounts for about 25% of why this fat distribution is linked to a lower risk of polycystic ovary syndrome.

Women of European ancestry with a genetic tendency to store more fat around the hips and thighs have a 15.5% lower risk of developing polycystic ovary syndrome, likely due to better insulin regulation and lower leptin levels, compared to those with different fat distribution patterns.

When overweight men eat fewer calories, it raises a protein in their blood that changes how their body uses testosterone, which can impact things like energy and health.

In individuals with polycystic ovary syndrome, a specific type of body fat around the hips and thighs appears to lower risk primarily by improving how the body responds to insulin, with fasting insulin levels accounting for most of this protective effect.

Women with PCOS might have more harmful chemicals called PFAS in their blood, and these could be linked to higher male hormone levels and worse symptoms — possibly because these chemicals mess with how hormones are made in the ovaries.