Understanding PMOS: Symptoms, Diagnosis and Treatment

Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously known as Polycystic Ovary Syndrome (PCOS), is one of the most common hormonal disorders impacting women, affecting roughly 1 in 10 women who have reached childbearing age. Even though PMOS is extremely common, the condition often goes undiagnosed because its symptoms can be mistaken for other disorders.

Dr. Semonti Hossain with EvergreenHealth Women's Specialty Care, Gynecology shared with Check-Up Chat that increasing awareness of PMOS (or PCOS) is essential for helping women recognize symptoms early and seek appropriate care.

What is PMOS?

PMOS is a disorder in your endocrine system that affects how the ovaries function and is caused by an imbalance in your reproductive hormones. This imbalance can lead to various health issues and symptoms, including:

• Irregular periods
• Extra hair growth specifically on the face, chest, abdomen, or upper thighs
• Acne and oily skin
• Fertility problems

PMOS can also lead to other health problems, like diabetes and heart disease.

Diagnosing PMOS

Diagnosis for PMOS typically means that you have a majority of what is called symptom clusters. As Dr. Hossain explained, "I go by a criteria called the Rotterdam criteria, where there's 3 symptom clusters. And if you have two out of the three, you meet the diagnostic criteria for [PMOS]."

The three most common symptoms or diagnostic clusters include:

• The first and most common indicator is irregular menstrual cycles. Women with PMOS may experience infrequent periods, sometimes going several months between cycles or having only a few periods each year. This irregularity often signals that ovulation is not occurring regularly.
• The second most common symptom is the presence of polycystic ovaries, usually identified through an ultrasound screening. These ovaries often contain multiple small cysts that can appear in a pattern sometimes described as a "string of pearls."
• The third symptom cluster involves elevated levels of male hormones, such as testosterone. Signs can include excess facial or body hair, male-pattern hair thinning, or darkened skin in areas such as the neck and underarms.

While these symptoms help identify PMOS, physicians also perform additional testing to rule out other causes of irregular periods. Blood tests may also assess cholesterol levels and blood sugar because PMOS is strongly associated with metabolic health concerns.

Impacts of PMOS

The impact to your health from PMOS extends beyond menstrual irregularities. Dr. Hossain emphasizes that the menstrual cycle should be viewed as a vital sign for women’s health. When cycles become irregular, it may indicate broader hormonal imbalances that can affect multiple organ systems.

One significant impact from PMOS is on your fertility. Because it is an ovulation disorder, you may ovulate less frequently than others without the condition, and this reduced frequency can make it more difficult to become pregnant naturally.

Due to menstrual irregularities, PMOS can also increase the risk of endometrial cancer. When menstrual periods occur infrequently, the uterine lining may not shed regularly, allowing abnormal changes to develop over time. Additionally, women with PMOS face a higher risk of insulin resistance, prediabetes, type 2 diabetes, and elevated cholesterol levels.

Obesity is often linked to PMOS as well, with lifestyle changes and weight management among the most effective treatment strategies for the condition. For some women, "as little as 10% weight loss can result in regulation of your cycles," Dr. Hossain said.

Treating PMOS

Your treatment plan can be tailored to your needs and goals. For instance, if you are not trying to conceive, hormonal birth control pills are often recommended to regulate cycles and reduce long-term health risks. If you are hoping to become pregnant, your provider may focus on strategies to improve ovulation and optimize fertility.

Although PMOS can be challenging to manage, early diagnosis and treatment can significantly improve symptoms and reduce risks to your health.

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