Polyendocrine Metabolic Ovarian Syndrome (PMOS)

What is PMOS? The New Name for PCOS

PCOS has been renamed PMOS — Polyendocrine Metabolic Ovarian Syndrome. The new name was adopted to better reflect the true nature of the condition, which extends well beyond the ovaries to affect the endocrine and metabolic systems more broadly.

The condition itself has not changed. The same symptoms, diagnosis criteria and treatment pathways apply. If you have previously been diagnosed with PCOS, that diagnosis remains valid — you may simply see the condition referred to as PMOS going forward.

Common Questions About PMOS (PCOS):

What is the difference between PCO and PMOs (PCOS)?
Polycystic Ovaries (PCO) are slightly larger than normal ovaries and have twice the number of follicles (small cysts). Up to one in three women have PCO. We see it a lot.

Keep in mind that to be diagnosed with Polycystic Ovarian Syndrome, however, a woman must also experience specific hormonal symptoms. These include irregular or missing periods, impacted ovulation and/or other hormonal symptoms.

PMOS (PCOS) is usually diagnosed via an internal ultrasound scan of the pelvis (also known as a trans-vaginalultrasound—trust us, not as scary as it sounds!)

Much like identical twins, PMOS (PCOS) and PCO are commonly confused, but they’re actually quite different. PCOS can greatly affect fertility, whereas PCO rarely does.

This page focuses on Polyendocrine Metabolic Ovarian Syndrome)—PMOS.

You may also see PCOS referred to as PMOS (Polyendocrine Metabolic Ovarian Syndrome) — the updated name that better reflects the condition’s wider impact on metabolic and endocrine health.

How does PMOS (PCOS) affect fertility?
PMOS (PCOS) can affect different women in different ways and to varying extents. It’s common for some women to be totally unaware they’re affected or to experience only very minor symptoms. Other women may experience a raft of symptoms.

Normally, a woman’s ovaries prepare several follicles each monthly cycle. These follicles will grow to ready for ovulation, though just one – the dominant – will mature enough to release its egg.

In a woman with PMOS, however, as many as 12 follicles develop in her ovaries. This means that no single follicle matures its egg enough to become dominant, which can impact ovulation.

The good news? For most women, a proper diagnosis and treatment plan is the first step to regaining control of the syndrome. And regaining control of the syndrome means regaining control of your reproductive health.

What are the causes of PMOS (PCOS)?
Frustratingly, there is currently no known cause of PMOS (PCOS). Women with the syndrome present with no single gene abnormality. Research suggests, though, that the syndrome could be the result of several different gene combinations. We describe this type of genetic circumstance as a ‘poly-genetic’ condition – in that multiple genes contribute to a possible inherited condition.

 

PMOS Symptoms (Formerly Listed as PCOS Symptoms)

Irregular or missing periods
Most women with this condition don’t have regular cycles or periods, which makes it tricky to pinpoint when they ovulate. Women with PMOS (PCOS) may experience irregular periods outside of the normal menstrual cycle (more or less often than once every 23-35 days). Or she may experience no periods at all – a condition known as amenorrhea. In some cases, women may experience extremely heavy periods or unpredictable intermittent bleeding.

Normally, when women ovulate it triggers a burst of the hormone progesterone. But when an egg isn’t released – as is the case with PMOS (PCOS) – it interrupts the normal progression of hormones needed for a woman to successfully ovulate.

This has a snowball effect: if ovulation doesn’t occur (anovulation), the ovaries continue to produce only two of the three necessary hormones – oestrogen and testosterone. This interrupted cycle is why a woman with PMOS (PCOS) may have no period at all or experience only infrequent bleeds.

Excessive facial or body hair
Due to an increase in male-type hormones (androgens), a woman with PMOS (PCOS) may experience an increase in facial or body hair. This is known as hirsutism. Hirsutism is likely to continue until androgen levels are lowered, so your fertility specialist will tend to this ASAP.

Areas of hair growth differ between women, but may include:

• a darkening and/or thickening of facial hair
• hair on the arms, legs, abdomen, back or chest
• an increase in pubic hair

Scalp hair loss
Similar to hirsutism (excessive body hair), high testosterone levels in women with PMOS (PCOS) can lead to male-pattern balding. This will continue to be an issue until testosterone levels are lowered. Again, your fertility specialist will be on the case.

Acne and/or oily skin
Acne or oily skin is a common first symptom of PMOS (PCOS). It can come as a surprise to women who are well past puberty, and really affect their self-esteem. Our counsellors are here for you if you need to vent or talk.

Acne is most likely to flare in hormone-sensitive areas such as the cheeks, jawline and neck. It might range from small bumps under the skin to larger, painful lumps that take a long time to clear.

Sudden or unexplained continuous weight gain
PMOS (PCOS) makes it difficult for the body to appropriately use the hormone insulin. Insulin normally helps to convert sugars and starches from our food into energy the body can use.

In a woman with PMOS (PCOS), the body becomes resistant to insulin and it builds up in the bloodstream. This leads to an increase of sugar and starch in the body—which results in weight gain. In turn, high insulin levels can trigger the release of more male-type hormones. Thankfully, these hormones don’t tend to increase a woman’s overall body fat. Though they can cause weight gain in specific areas such as the abdomen.

 

How PMOS Affects Your Hormones

Insulin
Insulin is a crucial hormone in the body. Produced by the pancreas, it controls the release of energy from the food we eat. Insulin has the important job of releasing or storing the correct amount of energy from our food.

The upshot? Our blood sugar remains at a normal level. If you have more sugar in your body than needed, insulin helps store it until later. You’ll be able to use the energy more effectively during physical activity, for example, or when your blood sugar level lowers in between meals.

However, many women with PMOS (PCOS) have what is called insulin resistance. This means that the cells in the body reject the normal level of insulin. If this occurs, the body starts to produce extra insulin to keep up with its blood sugar level. This in turn makes the body produce an overload of testosterone.

Androgens
Androgens are often called male hormones or male-type hormones. But don’t let that fool you – both men and women produce androgens, just in different amounts.

The two main androgens are testosterone and androstenedione. In men, these play a role in important male traits and in the reproductive system. In women, androgens’ primary purpose is to be converted into female hormones called oestrogens.

In women with PMOS (PCOS), however, the body produces more androgens than needed. This can prevent the ovaries from successfully releasing an egg during each menstrual cycle. It can also lead to symptoms such as increased body/facial hair and acne, mentioned above.

 

Managing and Treating PMOS (PCOS)

Lifestyle changes
Happily, women with PMOS (PCOS) can help ease their symptoms by committing to a healthy lifestyle. Maintaining a healthy weight and increasing your daily exercise are two important and manageable – first steps. Exercise and weight loss will help reduce any further health risks linked to the condition.

Statistically, around 75% of women with PMOS (PCOS) are overweight, with 50% of those women being obese.

The encouraging part? Overweight women with PMOS (PCOS) can reduce the effects of their symptoms by losing just 5-10% of their body weight!

Studies show that this small amount of weight loss can combat symptoms by:

• reducing insulin resistance by up to 50%
• restoring ovulation
• improving fertility
• increasing overall emotional health

For overweight women experiencing PMOS (PCOS) symptoms, we encourage you to focus on losing even a kilo or two. It really can make a difference.

Metformin
Metformin is a medication that helps the body’s response to insulin. It’s commonly prescribed to treat Type-2 Diabetes. It’s also used in women with PMOS (PCOS) whose systems are over-producing insulin and testosterone.

Metformin works by increasing the body’s sensitivity to insulin, helping it to accept the normal amount produced. Metformin can only be prescribed by your medical practitioner, so it’s a good idea to make an appointment with a fertility specialist if you haven’t already.

Hormonal birth control
It may seem counterintuitive, but taking some form of hormonal birth control may improve your chances of maintaining (or regaining) a regular period. The oral contraceptive pill works using two synthetic hormones; progestin and oestrogen – to lower and regulate hormone levels. It also lowers androgen (male hormone) levels. As a result, the oral contraceptive pill can help combat PMOS (PCOS) symptoms such as increased body hair and acne.

Anti-androgen medications
Although less commonly prescribed than Metformin, anti-androgen medications work to block the effect of androgens in women with PMOS (PCOS). Their aim is to reduce symptoms such as acne, increased body/facial hair and scalp hair loss.

Just remember to have a thorough chat with your doctor before starting a new medication. This way, they can explain in-depth how the medication works and outline any potential side effects. Keep in mind, you may need to stop certain PCOS medications before trying to get pregnant.

Emotional issues
If you are struggling to deal with the symptoms of PMOS (PCOS), please take heart – you are not alone. Research shows that women with PMOS (PCOS) experience higher levels of anxiety and depression than the general population. So please reach out to our friendly counselling team if you need some extra support to see you through.

Some women react to their PMOS (PCOS) diagnosis with a form of grief. This is completely normal and understandable. You may experience emotions such as shock, anxiousness, numbness, disbelief, anger and frustration – which can impact your overall emotional health. Certain PMOS (PCOS) symptoms such as weight gain and an increase in body or facial hair can also lead to poor self-image and self-esteem.

When you’re struggling with your mental health, it can be difficult to find the motivation to follow a healthy lifestyle. But hang in there if you can. Remember, even minor exercise and weight loss can greatly improve your PMOS (PCOS) symptoms – which in turn may brighten your mood.

At Repromed, we understand that conditions like PMOS (PCOS) can be tough to deal with. That’s why we offer our patients comprehensive counselling services. Checking in with one of our experienced counsellors can help you reduce stress and maintain good mental health.

 

How PMOS (PCOS) Affects Fertility and Conception

PMOS (PCOS) is a leading cause of female infertility. As we mentioned above, a woman with the condition may experience irregular periods due to an increase of male-type hormones known as androgens. These hormones can prevent ovulation, which in turn makes it difficult to conceive naturally. Overweight or obese women with PMOS (PCOS) have the most difficulty conceiving – either naturally or with fertility help.

The cheering bit? With the right treatment, 60% of women with PMOS (PCOS) can conceive naturally without any fertility clinic intervention.

 

Fertility Treatment Options for PMOS (PCOS)

Monitoring ovulation
Monitoring your ovulation is a great way of managing your fertility and getting to know your own cycle. In women with PMOS (PCOS), though, irregular periods make it tricky to determine when exactly you’re ovulating.

The best way to monitor your ovulation? By checking your cervical mucus. Cervical mucus is the small amount of pale-coloured discharge released from your vagina. Just before you ovulate, it becomes slippery and clear like an egg white, which allows the sperm to pass through it easily.

This is your body’s way of telling you: hey, you’re about to ovulate!

If you’d like a bit more guidance, you can also buy ovulation predictor kits from your local pharmacy. These kits help determine when you’re ovulating by testing your urine or saliva.

Ovulation induction and timing to achieve pregnancy
For some women with PMOS (PCOS), lifestyle, weight loss and ovulation tracking may not improve their fertility. In this case, ovulation induction (OI) can be a good option. OI is a treatment designed to stimulate the ovaries to produce more eggs by using tablets or injections over a sustained period of time.

Your fertility specialist may prescribe oral medications to increase hormone production from the pituitary gland. The goal is to increase your number of healthy egg follicles. Your specialist will monitor follicle growth via ultrasound. Once they’ve grown to the right size, you may spontaneously ovulate. Otherwise, your specialist will give you an injection to trigger ovulation.

For women with PMOS (PCOS), tracking when you ovulate can greatly improve your fertility by helping you determine the best time to have sex (known as your fertile window). This drastically increases your chances of falling pregnant over ‘blind’ intercourse.

Assisted reproductive technology
If you’re experiencing symptoms of PMOS (PCOS) and are concerned about them impacting your fertility, we recommend you consult a fertility specialist. They can help put your mind at ease and answer any questions you might have. By introducing simple management options like ovulation induction, your specialist can greatly improve your chances of falling pregnant.

Your fertility specialist may recommend IVF as the best option for you if strategies such as timed intercourse have failed to achieve pregnancy, or if you’re dealing with other complications like blocked fallopian tubes.

 

We completely understand that getting some fertility help may feel difficult or daunting at first. We’re here to make the process as simple and stress-free as possible.

A great first step is to have a confidential chat with our team. They can help get the ball rolling by recommending a fertility specialist with expertise in PMOS (PCOS).