PMOS (formerly known as PCOS)
Polyendocrine Metabolic Ovarian Syndrome is the most common hormonal problem to affect women of reproductive age. Insulin resistance has been shown to play a major role in the development of PMOS, a trait that it shares with another common endocrine disease, type 2 diabetes. The symptoms of PMOS can vary considerably between individuals but often include irregular periods, acne, excessive hair growth, difficulties with weight and reproductive challenges. These symptoms can also vary in severity within the same woman over time.
Whilst there is no cure at present for PMOS the symptoms can often be effectively managed. A healthy lifestyle and maintenance of a healthy body weight is important for managing symptoms and also for addressing the long-term metabolic consequences.
What is PMOS?
- Polyendocrine Metabolic Ovarian Syndrome affects 1 in 8 women
- PMOS can present in different ways for everyone. 2 out of 3 criteria are needed to confirm a diagnosis:
- Irregular periods (more or less often than monthly)
- High levels of androgens (male sex hormones including testosterone), either on a blood test or presenting as acne or excess hair growth
- Multiple ovarian follicles seen on ultrasound, or high levels of AMH on a blood test
Why was the name changed?
- The previous name, Polycystic Ovary Syndrome, is misleading. Most women with the condition do not actually have ovarian cysts, and the presence of ovarian cysts is not required to diagnose the condition. This has led to delays in individuals receiving the right diagnosis and care
- The new name, Polyendocrine Metabolic Ovarian Syndrome, better represents the condition as being multifaceted, affecting multiple endocrine (hormonal) systems as well as metabolic health.
What are the symptoms and features of PMOS?
- Acne
- Hirsutism (excess facial or body hair)
- Male pattern hair loss
- Irregular menstrual cycles
- Insulin resistance. Insulin is the hormone that regulates blood glucose. In PMOS, cells of the body become resistant to insulin, which leads to the pancreas working harder to make higher levels of insulin
- Increased risk for the metabolic syndrome (including type 2 diabetes, high cholesterol and high blood pressure)
- Depression
Every individual is affected differently and may not have all of the above.
What are the treatment options?
- Keeping active and eating a healthy diet most of the time are the foundations of managing PMOS.
- The combined oral contraceptive pill can improve cycles, and reduce acne and excess face/body hair
- Spironolactone, or other androgen-blocking medications, may also help with acne and excess hair
- Metformin is a good treatment for insulin resistance, and may help to regulate the menstrual cycles and promote ovulation
- Threading, waxing, laser and light therapy can be effective for treating excess face/body hair
How does PMOS impact on fertility?
- PMOS may cause irregular menstrual cycles, and can stop ovulation
- Most women with PMOS will be able to get pregnant and achieve their desired family size
- Around 70% may require extra support to get pregnant. For example:
- Tablets such as letrozole, clomiphene citrate and metformin
- Injections
- IVF
- Healthy lifestyle choices are important to improve the chances of a healthy pregnancy:
- Keeping active
- Maintaining a healthy body weight, or losing 5-10% of body weight if you are overweight or obese
- If you are planning to have children, plan to have them before the age of 35 if possible
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