PMOS is the new PCOS: What does that mean?

Key Takeaways:

• The condition formerly known as polycystic ovarian syndrome, or PCOS, is now called polyendocrine metabolic syndrome, or PMOS, to better recognize its complexities.
• While no cure exists, treatment is available.
• A diagnosis of PMOS does not equal infertility. Some with PMOS can get pregnant on their own, and others may need medical assistance to conceive.

In May, a research study published in The Lancet announced the results of a push of more than a decade to rename polycystic ovarian syndrome, or PCOS, to polyendocrine metabolic syndrome, or PMOS.

In this blog, we’re going to talk about what it is, how it’s diagnosed, and how it’s treated.

What is PMOS?

This new name better represents the complexity of the disease that we see. It’s not just disease involving the ovaries. It involves multiple disruptions and hormone pathways in our body, including androgen hormones and insulin pathways.

How is it diagnosed?

We think about three main symptoms: irregularities with your menstrual cycle, which commonly means skipping cycles or going months without a period; elevated testosterone levels, which we can see by doing blood work or with clinic signs of unwanted hair growth or bothersome acne; and enlarged ovaries on ultrasound imaging usually due to clusters of multiple small cysts on the ovaries.

If you have any combination of two out of those three symptoms, you may meet criteria for PMOS.

What are common PMOS misconceptions?

One of the big misconceptions with PMOS involves ovarian cysts.

Not all ovarian cysts are abnormal; some may be part of our normal menstrual cycle. And not all abnormal ovarian cysts will equate to PMOS.

Our body naturally produces cysts on our ovaries as part of our normal menstrual cycle to help us ovulate. Those are the normal cysts we see. That wouldn’t necessarily mean you have PMOS.

With PMOS, that hormone pathway is disrupted, so you have these clusters of small cysts that fill the ovaries rather than one cyst to ovulate from, which is when it becomes more abnormal.

Other cysts that grow on our ovaries include things like endometriomas or dermoid cysts to name a few. These are different from PMOS and have different treatment pathways.

It’s important for us as providers to delineate the difference in ovarian cysts, so we can make best recommendations for monitoring and/or treatment.

If I receive a PMOS diagnosis, does it mean I’m infertile?

Thankfully, PMOS does not equal infertility.

Yes, it can be harder to achieve a pregnancy on your own with PMOS. As mentioned before, the hormone signaling pathways are disturbed in PMOS, making it harder to ovulate regularly.

However, there are instances where the pathways function normally, and we do see spontaneous pregnancies. For this reason, if you have PMOS and you’re not trying to get pregnant, we recommend some form of contraception.

If you have PMOS and you’re having difficulties conceiving, we also have medications we can prescribe to help you ovulate and conceive.

There’s no known cure for PMOS, but how is it treated?

Treatments are tailored based on your symptoms and your goals.

As a gynecologist, we frequently deal with menstrual cycle irregularities in PMOS. Your goals of care could be regulating your cycle to protect your uterus from the harmful effects of skipping periods, or it could be regulating your cycle to help you conceive.

We may discuss birth control to help regulate cycles, or on the other hand, we may discuss other hormonal medications to help you ovulate more regularly and achieve a pregnancy.

We also may discuss interventions to help promote healthy living, including diet and exercise, to help prevent the risk of diabetes and cardiovascular disease that can come with PMOS. We also may discuss treatments for the elevated testosterone levels if that’s your main symptom.

Next steps

If you think you may have PMOS, talk to your OB/GYN. If you don’t have one yet, WVU Medicine can help.

We offer comprehensive medical care for women across the lifespan, including routine gynecologic care, maternity and newborn services, specialty gynecology, pelvic medicine, minimally invasive surgery, sexual medicine, and reproductive medicine.

The services we provide include evaluation, diagnosis, medical and surgical treatment options, and classes to prepare families for childbirth and early parenting.

For more information, click here