Polyendocrine metabolic ovarian syndrome (PMOS)A common hormonal and metabolic condition

Formerly known as polycystic ovarian syndrome (PCOS), PMOS is a common hormonal and metabolic condition involving elevated levels of the male hormone, androgens.

Woman sitting on a bed holds a model of female reproductive organs, illustrating polyendocrine metabolic ovarian syndrome.

Affecting one in eight women of reproductive age globally, it’s one of the most common reasons for difficulty conceiving because periods are irregular and the ovaries don’t release an egg regularly. In addition to contributing to infertility, the hormonal imbalance found in PMOS can affect other aspects of long-term health.

What are the symptoms of PCOS/PMOS?

Symptoms vary between women and also change as your body does. Common PMOS/PCOS symptoms include:

  • Unpredictable or absent periods 
  • Acne-prone skin
  • Hair loss on the scalp
  • Excessive hair growth on the torso
  • Weight gain and difficulty with weight loss
  • Low mood
  • Fatigue
  • Fertility challenges

How does PMOS affect fertility? 

Because ovulation is either irregular or absent, PMOS interferes with fertility and conception in the following ways:

  • If you don’t release an egg regularly there are fewer chances to conceive
  • Higher androgens (hormones that influence male traits) can affect egg development and ovulation 
  • Insulin resistance and metabolic changes can impact egg development, the uterus, and long-term health
  • Unpredictable cycles make it harder to know when you’re fertile

How is PMOS diagnosed? 

Dr Ritu will begin by taking a detailed history of your symptoms, including changes to your periods, weight, skin, hair and energy levels. She will also look at whether your symptoms suggest hormone imbalance, insulin resistance, or another underlying issue that may be contributing to PMOS.

She may arrange blood tests to check hormone levels and metabolic markers, helping to identify changes that can affect your cycles, fertility and long-term health. A pelvic ultrasound may also be organised to assess the appearance of your ovaries and uterus and to look for features that support a PMOS diagnosis.

Once all of this information is together, Dr Ritu can confirm the diagnosis and explain what it means for your health and fertility in clear, practical terms.

How is PMOS/PCOS treated?

Dr Ritu will tailor your PMOS treatment to your symptoms, goals and overall health. Depending on how PMOS is affecting you, she may recommend treatment to regulate your cycle, improve hormone balance, manage skin and hair symptoms, support fertility, and monitor any longer-term health risks.

Medications

The primary aim of medications for PCOS/PMOS is to address the hormonal imbalance contributing to your symptoms. These include anti-androgen medications or other hormone-based medications that can address the skin and hair effects of PMOS. Some of these medications also come with contraceptive effects, so it is important to raise your family plans with Dr Ritu before starting treatment. Metformin, a diabetes medication, is also often considered to address the insulin resistance found in PMOS. 

Lifestyle support

Lifestyle changes can play an important role in improving insulin sensitivity, hormone balance and overall wellbeing. Dr Ritu may guide you on practical changes that support both your general health and your reproductive health. These can include weight loss, dietary recommendations, and physical exercise.

Managing skin and hair symptoms

PMOS can cause concerns such as acne or excess hair growth, which can be distressing and affect confidence. Cosmetic treatments such as laser hair removal or skin therapies can be helpful here.

Ongoing monitoring

PMOS is associated with increased risks of various conditions, including cardiovascular disease, diabetes, osteoporosis, sleep apnoea, and endometrial cancer. If you live with PMOS, ongoing monitoring of your overall health over time is vital to manage these potential complications.

Fertility treatment

If you are hoping to conceive, Dr Ritu can help you understand how PMOS may be affecting ovulation and fertility. In many cases, managing your weight with lifestyle changes can help to support ovulation and natural conception. Not all women with PMOS will experience fertility problems, but if it is identified as causing infertility, you have options.

Ovulation induction

Hormone medications can encourage your ovaries to release an egg to allow for timed intercourse.

In vitro fertilisation (IVF) or intrauterine insemination (ICSI)

If lifestyle changes or ovulation induction medications are not successful, more intensive interventions with assisted reproductive technologies may be needed to help you conceive. These include IVF, which combines your eggs and your partner’s or donor’s sperm in a laboratory dish, or ICSI, which involves an embryologist injecting a sperm cell directly into each egg for fertilisation.

FAQs about PMOS

PMOS is the newer term used to better reflect the hormonal and metabolic nature of the condition. It describes the same broad group of symptoms and concerns that many people previously knew as PCOS, including irregular periods, ovulation issues and metabolic changes.

Yes, PMOS can affect much more than fertility. It may also influence your periods, skin, hair, weight, energy levels, mood and long-term metabolic health, which is why a broader treatment plan is often helpful.

Yes, treatment can still be useful even if pregnancy is not your current goal. Managing PMOS can help regulate periods, improve symptoms, support overall wellbeing, reduce longer-term health risks, and in some cases improve ovulation and fertility for when you are ready to try to conceive.

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