The cause of POTS is unknown. It is often seen after certain events that can cause physical stress, such as infection and concussion, or after pregnancy. However, it is not certain if these events cause POTS or are merely associated with it.
Genetics and family history play a role in POTS, but the specific genes responsible are as yet undefined. Furthermore, conditions that may affect muscle control or connective tissue function, (e.g., Ehlers-Danlos syndrome) or are associated with hormonal changes (e.g., puberty or menopause), may also cause POTS.[1]