Polyendocrine Metabolic Ovarian Syndrome (PMOS)
Ohio State experts can diagnose and treat conditions related to PMOS, which used to be called polycystic ovary syndrome (PCOS).
If you’ve experienced irregular periods, facial hair, unexplained weight changes or difficulty getting pregnant, these seemingly unrelated symptoms may be caused by a common hormonal and metabolic condition called PMOS, or polyendocrine metabolic ovarian syndrome.
PMOS, formerly known as polycystic ovary syndrome (PCOS), affects 1 in 8 women of reproductive age. The experts at The Ohio State University Wexner Medical Center in Columbus, Ohio, collaborate to improve the quality of life for those with PMOS. Because PMOS is a complex condition that affects multiple systems, our Center for Women’s Health brings together trusted experts in endocrinology, gynecology, nutrition and even dermatology to address your needs from every angle.
What is PMOS?
PMOS is a common, complex hormonal and metabolic condition that affects the body's endocrine system. It can interfere with ovulation, alter hormone production, cause insulin resistance and increase your risk of metabolic conditions like type 2 diabetes and heart disease.
While many people still recognize the older name PCOS, PMOS more accurately reflects the wide-ranging effects the condition has on the body. With the right care, PMOS is treatable and manageable.
Why was PCOS renamed PMOS?
The name change better reflects how it affects multiple body systems – and that it doesn’t lead to ovarian cysts, as the former name suggests. The designation “PMOS” captures the full range of endocrine and metabolic concerns you may experience.
Instead of ovarian cysts that are prone to rupture, people with PMOS actually have fluid-filled eggs that aren’t ovulating and instead become trapped in the ovaries. The name change recognizes this distinction and helps avoid misleading ultrasound conclusions. Patients, medical experts and healthcare societies collaborated to change the name, which will help providers identify and treat this condition earlier by acknowledging its many symptoms.
What causes PMOS?
The exact cause of PMOS is unknown, but scientists believe several factors play a role. These include:
- Hormonal imbalances: Many people with PMOS produce higher-than-normal levels of a hormone, androgen, that acts like testosterone. This can disrupt ovulation and contribute to symptoms like acne and excess hair growth.
- Insulin resistance: Insulin helps regulate blood sugar. When the body doesn't respond to insulin effectively, it produces more insulin to keep blood sugar levels in check. This can contribute to weight gain and other symptoms.
- Genetics: PMOS often runs in families.
Symptoms of polyendocrine metabolic ovarian syndrome
PMOS can look different from one person to another. Some people experience only a few symptoms, while others face multiple health challenges. Symptoms include:
- Excess male hormones, or androgens
- Excess male-patterned hair growth known as hirsutism
- Acne
- Thinning hair on the scalp
- Infrequent or irregular menstrual periods
- Infertility
- Immature eggs in the ovaries that resemble cysts
- Weight gain
If you’re not on birth control and naturally aren’t having menstrual cycles, you should seek medical care.
PMOS diagnosis and treatment at Ohio State
Lekshmi Nair, MD, shares all the ins and outs of navigating symptoms, diagnosis and management of PMOS. While the condition can't be cured, she reassures people that it can be managed successfully with the expert and collaborative care Ohio State provides.
PMOS and fertility
While PMOS can affect ovulation and make it more difficult to conceive, many people with PMOS become pregnant naturally or with fertility treatment. Early evaluation and personalized care from a PMOS gynecology expert can improve your chances of a healthy pregnancy.
Our expert obstetricians can provide initial infertility evaluation and treatment as well as a referral to some of the region’s top reproductive endocrinologists in our partners at Ohio Reproductive Medicine. Together, we can help you achieve a healthy pregnancy if you’re struggling to become pregnant because of PMOS.
How is PMOS diagnosed?
PMOS is typically diagnosed based on having at least two of three criteria:
- A history of irregular, prolonged, skipped or absent periods
- Hair growth that’s coarse, darker and in atypical places for females
- Immature eggs or follicles that are visible in an ultrasound screening and look like a string of pearls
It’s also important to exclude any secondary causes or other conditions at the time of PMOS diagnosis, such as thyroid disorders, pituitary disorders and early menopause.
Treatment options
There’s currently no cure for polyendocrine metabolic ovarian syndrome, but there are treatment options. Identifying the condition early helps improve your quality of life and reduce your risk of metabolic complications caused by insulin resistance – such as type 2 diabetes, heart disease, hypertension, metabolic liver disease, sleep apnea and high cholesterol.
Treatments include:
- Medication: Many of the medications for PMOS have been around for a long time and can help improve symptoms.
- Hormonal therapy: Birth control can improve both irregular and heavy periods. This can also help with some of the skin-related symptoms of PMOS.
- Diet: A healthy, balanced diet with the help of a dietitian can regulate insulin resistance and body weight.
- Exercise: Exercise, especially routines that include both cardiovascular and strength training, can ease symptoms and improve overall management of the condition.
- Dermatology: Skin experts provide treatments for acne and reducing or removing facial hair.
- Counseling: Managing challenges such as excess hair growth, irregular periods and reproductive concerns may require mental healthcare, including condition- and person-specific psychotherapy.
- Metabolic screening: Identifying the condition earlier can help address the higher risk for diseases like type 2 diabetes, metabolic liver disease, sleep apnea, and heart disease.
PMOS support throughout your life cycle
Puberty: Support and treatment for symptoms like menstrual irregularity and male-pattern hair growth from excess testosterone.
Reproductive years: Support and treatment to improve menstrual regularity and induce ovulation to support fertility.
Menopause: Increased screening to address higher risks of metabolic disease, such as type 2 diabetes, cardiovascular disease and metabolic-associated liver disease.
Why choose Ohio State?
Ohio State endocrinologists and gynecologists at the Center for Women's Health have teamed up to offer continuous care throughout the reproductive life cycle for women with PMOS. Because this chronic condition affects so many areas of health, our providers work together so you can conveniently connect to all of them in one place. From your initial visit to treatment, we develop a personalized plan to manage your symptoms.
Our collaborative care model for PMOS includes:
- Endocrinology
- Gynecology
- Dermatology
- Behavioral health
- Nutrition
- Primary care