The following factors have been implicated in its pathogenesis:

1. Hormonal imbalance: PCOD is characterized by hormonal imbalances, including elevated levels of androgens (male hormones) such as testosterone, and abnormal levels of insulin and luteinizing hormone (LH). 
2. Ovarian dysfunction: PCOD is associated with a variety of ovarian abnormalities. These include the presence of multiple small cysts on the ovaries (polycystic ovaries), as well as irregular or absent ovulation. 
3. Insulin resistance: Many women with PCOD exhibit insulin resistance, which is a condition where the body's cells become less responsive to the effects of insulin. This leads to increased insulin production and higher insulin levels in the blood. 
4. Metabolic abnormalities: PCOD is often accompanied by metabolic abnormalities, such as obesity, dyslipidemia (abnormal lipid levels), and impaired glucose tolerance. 
5. Genetic factors: There is growing scientific evidence supporting a genetic component to PCOS. Studies have identified several candidate genes that may contribute to the development of PCOS. However, the exact genetic mechanisms and their interactions with environmental factors are still being investigated.
6. Long-term health implications: PCOS is associated with an increased risk of various long-term health complications, including type 2 diabetes, cardiovascular disease, and endometrial (uterine) cancer. Scientific studies have demonstrated these associations, emphasizing the importance of early diagnosis, regular monitoring, and lifestyle interventions to reduce these risks.