Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly PCOS)

PMOS at a glance

• Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a complex disorder with multi-system effects, including on metabolic health, reproductive health, and psychological health.
• PMOS affects about 10% of people with ovaries between puberty and menopause.
• With PMOS, small follicles (egg-containing cysts) in the ovaries do not develop eggs properly, disrupting ovulation and leading to an excess of androgen, a male hormone.
• Symptoms of PMOS are irregular or absent menstrual periods; excessive hair growth on the face, back, or chest; acne; weight gain; and insulin resistance.
• While no cure currently exists for PMOS, the symptoms can be treated and managed through medication and healthy lifestyle choices.

Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

PMOS, sometimes known as PCOS, Stein-Leventhal syndrome, or hyperandrogenic anovulation, is a common hormonal disorder that affects around 5 to 6 million of people with ovaries in the United States, according to the Endocrine Society. It is considered to be the most common hormonal imbalance disorder in reproductive-aged patients.

PCOS has a new name: Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Why the change?

The term Polyendocrine Metabolic Ovarian Syndrome (PMOS) more accurately reflects the wide range of systems affected by this condition, including hormonal balance, metabolism, mental health, skin, and the reproductive system.

This updated name aims to improve patient care by supporting earlier and more accurate diagnoses, while also enhancing awareness, understanding, and education among medical professionals.

Symptoms of PMOS

PMOS is a hormonal disorder, so the symptoms are widespread throughout the body. Not all patients with PMOS have the same symptoms.

People with PMOS may have any of the following symptoms:

• Irregular or absent menstrual periods
• Acne
• Excessive hair growth on the face, back, or chest (hirsutism)
• Elevated male hormone levels
• Polycystic-appearing ovaries (more than 12 peripheral follicles)
• Weight gain or difficulty losing weight
• Evidence of diabetes or insulin resistance
• High blood sugar (hyperglycemia)
• High cholesterol

For ovulation to occur, a normal, estrogen-dominant environment must be present in the ovary. In patients with PMOS, there is a higher amount of androgen released by the ovaries, and the hormonal balance between estrogen and androgen is disrupted, leading to ovulation problems.

Over time, PMOS can lead to a hormonal imbalance in the patient's entire system, affecting fertility and causing other serious health issues such as diabetes, heart disease, or hypertension. Persons with PMOS are also at a higher risk for endometrial and uterine cancer.

Causes of PMOS

Currently, the causes of PMOS are unknown. However, since individuals with PMOS are more likely to have a close relative with the syndrome as well, researchers think that genetics may be a factor.

In addition, people with a family history of diabetes may be at higher risk of developing PMOS.

PMOS treatment

There is no known cure for PMOS, but there are several forms of treatment available that can help manage the symptoms of this lifelong medical condition. In order to prevent the long-term health risks posed by PMOS, patients should begin treatment as soon as they are diagnosed.

Patients with PMOS should be checked regularly for the following conditions:

• High cholesterol
• High blood pressure
• Heart disease
• Diabetes
• Uterine cancer

Maintaining a healthy weight through diet and regular exercise is the most effective treatment for PMOS. Although PMOS can be managed with certain types of medication, good nutrition and weight loss can reduce the risks of diabetes or heart disease and lower insulin levels, as well as improve ovulation and fertility.

Cosmetic procedures, such as electrolysis or laser hair removal, can treat excess hair growth. Some medications, including birth control pills, may help with hair loss, acne management, or menstrual cycle regulation.

Related reading: ACOG patient resources